Individual
DR. SUSAN ANN MINEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
850 HARRISON AVE, YACC5, BOSTON, MA 02118-4001
(617) 414-5946
(617) 414-4541
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
77543
MA
2080P0006X
Developmental - Behavioral Pediatrics Physician
77543
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110055093A
—
MA
Enumeration date
03/24/2006
Last updated
05/13/2014
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