Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | M3094 | TX |
NPI | 1003852740 |
---|---|
Provider Name | Dr. Marian B Sussman |
First Address | Corpus Christi, TX 78466-0233 |
Second Address | Corpus Christi, TX 78411-1820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 19/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C58925 | (02) | TX |