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Individual

SUSAN TERI MCGILLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
230 HARRISBURG AVE, STE 4, LANCASTER, PA 17603-2959
(717) 399-9800
(717) 399-7613
Mailing address
230 HARRISBURG AVE, STE 4, LANCASTER, PA 17603-2959
(717) 399-9800
(717) 399-7613

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
35058536M
OH
207N00000X
Dermatology Physician
MD430176
PA
207ND0101X
MOHS-Micrographic Surgery Physician
MD430176
PA
207NS0135X
Procedural Dermatology Physician
Primary
MD430176
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0761046
OH
Enumeration date
04/13/2006
Last updated
12/22/2016
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