Individual
DR. SUSAN A CHIARITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 MISSION 66, VICKSBURG, MS 39180-3711
(601) 636-8244
Mailing address
1901 MISSION 66, VICKSBURG, MS 39180-3711
(601) 636-8244
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14065
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112108
—
MS
Enumeration date
06/09/2006
Last updated
02/02/2010
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