MEDICARE: SUZANNE T MCGOEY 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
1	207ND0101X	MOHS-Micrographic Surgery Physician	4301101448	MI
2	207ND0101X	MOHS-Micrographic Surgery Physician	66181-20	WI
3	207N00000X	Dermatology Physician	66181-20	WI
4	207N00000X	Dermatology Physician	4301101448	MI

General Provider Information

NPI Number	:	1861756538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE T MCGOEY MD

Provider Business Mailing Address
First Line	:	832 MICHIGAN AVE
Second Line	:
City	:	SHEBOYGAN
State	:	WI
Zip	:	53081-3438
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	832 MICHIGAN AVE
Second Line	:
City	:	SHEBOYGAN
State	:	WI
Zip	:	53081-3438
Country	:	US
Telephone Number	:	920-926-8722
Fax Number	:

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

Provider Enumeration Date	:	06/27/2012
Last Update Date	:	04/10/2026

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