Individual
DR. SUSAN N DIEDERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
7511 HARWOOD AVE, WAUWATOSA, WI 53213-2606
(414) 453-1300
(414) 453-1330
Mailing address
7511 HARWOOD AVE, WAUWATOSA, WI 53213-2606
(414) 453-1300
(414) 453-1330
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2981-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38624700
—
WI
01
—
WI2981
EYEMED VISION NO.
—
Enumeration date
06/27/2006
Last updated
09/17/2025
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