Individual
MS. SUSAN MARIA CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7116 RITCHIE HWY, GLEN BURNIE, MD 21061-2904
(443) 577-0277
(443) 577-0288
Mailing address
PO BOX 759047, BALTIMORE, MD 21275-9047
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0004772
MD
363A00000X
Physician Assistant
Primary
PA00565
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SC85902
—
RI
Enumeration date
11/11/2010
Last updated
06/13/2013
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