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NPI Code Detail

MEDICARE: SUSAN SCHAYES MD

MEDICARE: SUSAN SCHAYES MD
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
1207Q00000XFamily Medicine PhysicianME131905FL
2207Q00000XFamily Medicine PhysicianMD464175PA
3207Q00000XFamily Medicine Physician35.135432OH
4207Q00000XFamily Medicine Physician043278GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME131905OTHERFLSTATE LICENSE

General Provider Information

NPI Number : 1720183254
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN SCHAYES MD
Provider Business Mailing Address
First Line : 1395 NW 167TH ST
Second Line :
City : MIAMI GARDENS
State : FL
Zip : 33169-5710
Country : US
Telephone Number : 305-628-6117
Fax Number :
Provider Business Practice Location Address
First Line : 2124 CANDLER RD
Second Line :
City : DECATUR
State : GA
Zip : 30032-5572
Country : US
Telephone Number : 404-836-0272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 10/26/2021

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