MEDICARE: SUSAN E BITTENBENDER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	MD064712L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	070017406	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2337296	OTHER	PA	AETNA
2	50018384	OTHER	PA	CAPITOL BLUE CROSS
3	0696423000	OTHER	PA	INDEPENDENCE BLUE CROSS
4	976079	OTHER	PA	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1114988037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN E BITTENBENDER M.D.

Provider Business Mailing Address
First Line	:	1185 CHESTERSHIRE PL
Second Line	:
City	:	POTTSTOWN
State	:	PA
Zip	:	19465-9600
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 W LINFIELD TRAPPE RD
Second Line	:	SUITE 240
City	:	LIMERICK
State	:	PA
Zip	:	19468-4295
Country	:	US
Telephone Number	:	610-495-6500
Fax Number	:	610-495-6558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	06/13/2013

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Directions to “ SUSAN E BITTENBENDER M.D.” Practice Location

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