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NPI Code Detail

MEDICARE: MRS. SUSAN KAYE GAUS MSW

MEDICARE:  MRS. SUSAN KAYE GAUS  MSW
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
1104100000XSocial WorkerBP00940744WV

General Provider Information

NPI Number : 1316054281
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN KAYE GAUS MSW
Provider Business Mailing Address
First Line : 1 MEDICAL CENTER DR.
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-4059
Country : US
Telephone Number : 304-623-3461
Fax Number : 304-626-7726
Provider Business Practice Location Address
First Line : LOUIS A. JOHNSON VAMC
Second Line : 1 MEDICAL CENTER DRIVE
City : CLARKSBURG
State : WV
Zip : 26301-4059
Country : US
Telephone Number : 304-623-3461
Fax Number : 304-626-7726
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. SUSAN KAYE GAUS MSW” Practice Location

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