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General NPI Number Information
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NPI Number | 1922141530
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Entity Type | Individual
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Provider Name | SUZANNE MARIE BLAUSER MD
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/23/2010
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Provider Practice Location Address
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Address Line | 105 COLLIER RD NW SUITE 5040
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City | ATLANTA
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State | GA
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Zip | 30309-1710
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Country | US
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Telephone | 404-350-6647
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Fax |
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Provider Business Mailing Address
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Address Line | 2356 DELLWOOD DR NW
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City | ATLANTA
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State | GA
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Zip | 30305-4077
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Country | US
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Telephone | 404-605-0003
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 041266
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License Number State | GA
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