Healthcare Provider Details
I. General information
NPI: 1750543526
Provider Name (Legal Business Name): SUSAN KATHLEEN SAUNDERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/01/2008
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9795 PERRY HWY SUITE 100
WEXFORD PA
15090-9700
US
IV. Provider business mailing address
9795 PERRY HWY STE 100
WEXFORD PA
15090-9700
US
V. Phone/Fax
- Phone: 412-366-7337
- Fax:
- Phone: 412-366-7337
- Fax: 412-366-5118
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 442540 |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: