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General NPI Number Information
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NPI Number | 1366414054
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Entity Type | Individual
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Provider Name | SUSAN MANN-SWEENEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 3377 RIVERBEND DR. PEDIATRICS
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City | SPRINGFIELD
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State | OR
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Zip | 97477
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Country | US
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Telephone | 541-222-8500
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Fax | 541-222-6435
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Provider Business Mailing Address
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Address Line | 3377 RIVERBEND DR. PEDIATRICS
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City | SPRINGFIELD
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State | OR
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Zip | 97477-8004
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Country | US
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Telephone | 541-222-8500
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Fax | 541-222-6435
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD172023
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME96215
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 19006
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License Number State | AZ
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