Healthcare Provider Details

I. General information

NPI: 1053384446
Provider Name (Legal Business Name): SUSAN GIBSON DUNLOW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-5001
US

IV. Provider business mailing address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-5095
US

V. Phone/Fax

Practice location:
  • Phone: 301-400-2433
  • Fax:
Mailing address:
  • Phone: 301-400-2433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD00026070
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number00026070
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number00026070
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: