Individual
DR. SUSAN M. DASHOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
111 S 11TH ST STE 8490, PHILADELPHIA, PA 19107-4824
(215) 955-6161
(215) 923-5507
Mailing address
111 S 11TH ST STE 8490, PHILADELPHIA, PA 19107-4824
(215) 955-6161
(215) 923-5507
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MB05618600
NJ
207L00000X
Anesthesiology Physician
OS008234L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050071448
RAIL ROAD MEDICARE
NJ
01
—
0507477000
AMERIHEALTH PRODUCTS
NJ
01
—
2K2874
HEALTH NET
NJ
05
—
4596307
—
NJ
Enumeration date
09/30/2005
Last updated
01/15/2019
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