Healthcare Provider Details

I. General information

NPI: 1467524199
Provider Name (Legal Business Name): SUSAN H MAGNESS CARVER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 S 16TH ST
COSHOCTON OH
43812
US

IV. Provider business mailing address

507 S 16TH ST
COSHOCTON OH
43812
US

V. Phone/Fax

Practice location:
  • Phone: 740-622-8299
  • Fax: 740-622-4436
Mailing address:
  • Phone: 740-622-8299
  • Fax: 740-622-4436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35043965
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: