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General NPI Number Information
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NPI Number | 1093854218
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Entity Type | Individual
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Provider Name | SUSAN CAO M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 180 WINGO WAY STE 205
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City | MT PLEASANT
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State | SC
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Zip | 29464-1811
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Country | US
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Telephone | 843-256-7109
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Fax |
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Provider Business Mailing Address
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Address Line | 2256 BECKENHAM DR
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City | MT PLEASANT
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State | SC
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Zip | 29466-9009
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 41233
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 31477
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License Number State | SC
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