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General NPI Number Information
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NPI Number | 1952614075
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Entity Type | Individual
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Provider Name | SUSAN KARTIKO MD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2010
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Last Update Date | 04/26/2019
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Provider Practice Location Address
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Address Line | 2150 PENNSYLVANIA AVE NW FL 6
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City | WASHINGTON
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State | DC
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Zip | 20037-3201
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Country | US
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Telephone | 202-677-6219
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Fax | 202-741-3219
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Provider Business Mailing Address
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Address Line | 2150 PENNSYLVANIA AVE NW FL 6
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City | WASHINGTON
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State | DC
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Zip | 20037-3201
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Country | US
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Telephone | 202-677-6219
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Fax | 202-741-3219
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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 | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 267696
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 267696
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD047306
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License Number State | DC
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