Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 35061619K | OH |
Y | 207ND0900X | Dermatopathologist | 35061619K | OH |
NPI | 1780660407 |
---|---|
Provider Name | Dr. Susan E. Kindel |
First Address | Addison, TX 75001-3614 |
Second Address | Cincinnati, OH 45242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 26/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F05326 | (02) |