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Individual

SUSAN LANE O'LEARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1470 MEDICAL PKWY, SUITE 160, CARSON CITY, NV 89703-4648
(775) 445-7650
(775) 882-4206
Mailing address
PO BOX 4390, CARSON CITY, NV 89702-4390
(775) 445-7650
(775) 882-4206

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
12741
NV
207RC0000X
Cardiovascular Disease Physician
A105681
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1760697940
NV
Enumeration date
05/11/2007
Last updated
09/18/2014
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