Individual
SUSAN M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
Mailing address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
53408
AZ
207L00000X
Anesthesiology Physician
66740
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100065488
—
WI
Enumeration date
07/17/2008
Last updated
06/01/2022
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