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Individual

SUSAN T MYERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
380 HOSPITAL DRIVE, SUITE 410, MACON, GA 31217
(478) 746-5644
(478) 745-4849
Mailing address
PO BOX 2564, MACON, GA 31203
(478) 746-5644
(478) 745-4849

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN55281 CRNA
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000519472C
GA
05
000519472H
GA
05
000519472I
GA
05
000519472J
GA
01
326798
WELLCARE
GA
01
430039255
RAILROAD MEDICARE
GA
Enumeration date
08/04/2006
Last updated
06/04/2013
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