Individual
SUSAN J HASKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 SINGLETON RIDGE RD, CONWAY, SC 29526-9142
(843) 669-5162
(843) 667-4573
Mailing address
PO BOX 100523, FLORENCE, SC 29501-0523
(843) 669-5162
(843) 667-4573
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
11026
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110267
—
SC
01
—
155031900
US DEPT OF LABOR
SC
01
—
25091
MEDCOST
SC
01
—
570835798
STANDARD TAX ID
SC
05
—
7905936
—
NC
Enumeration date
01/17/2007
Last updated
10/23/2007
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