Individual provider · Type 1 NPI
Kenneth Roger Susman, MD
Specialist · Fort Bragg, CA
NPI number
1962551119
Active
Practice location
510 Cypress St, Suite B
Fort Bragg, CA 95437-5411
Fax (707) 961-1978
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | G679520 (CA) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
3 other providers at this address
About NPI 1962551119
Kenneth Roger Susman, MD's National Provider Identifier is 1962551119, issued on Jan 9, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Fort Bragg, CA. The record was last updated on Jul 8, 2007.