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Individual

DR. SUSAN WILLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4920 CAMPBELL BOULEVARD, BALTIMORE, MD 21236-5916
(410) 933-7600
(410) 933-7601
Mailing address
2101 EAST JEFFERSON STREET, PPQA MEDICARE COMPLIANCE UNIT 6 WEST, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D0021264
MD

Other

Enumeration date
12/04/2006
Last updated
07/08/2007
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