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Individual

DR. SUSANNA S LAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2406 BLUE RIDGE RD, SUITE 100, RALEIGH, NC 27607-6678
(919) 786-5001
(919) 786-5051
Mailing address
2406 BLUE RIDGE RD, SUITE 100, RALEIGH, NC 27607-6678
(919) 786-5001
(919) 786-5051

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
P1778
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P1778
MEDICAL LICENSE
TX
01
PG112929
MEDICAL MUTUAL
NC
Enumeration date
04/06/2011
Last updated
06/12/2012
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