Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC006388 | PA |
Y | 222Z00000X | Podiatrist | SC006388 | PA |
N | 213ES0103X | Foot & Ankle Surgery | SC006388 | PA |
NPI | 1013271873 |
---|---|
Provider Name | Dr. Mehgan M Susek |
First Address | Danville, PA 17822-4903 |
Second Address | Wilkes Barre, PA 18702-7906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2012 |
Last Update Date | 17/08/2020 |