Individual
DR. SUSAN ELIZABETH INGRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-1956
(352) 265-0301
Mailing address
PO BOX 100296, GAINESVILLE, FL 32610-0296
(352) 627-9350
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
18713
HI
2080P0210X
Pediatric Nephrology Physician
35-088687
OH
2080P0210X
Pediatric Nephrology Physician
Primary
ME170713
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3147866
—
OH
Enumeration date
11/17/2008
Last updated
11/07/2024
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