MEDICARE: DR. SUSAN LINDSAY HOLLANDER M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	29502	OK
2	2084N0400X	Neurology Physician	2011010349	MO
3	2084N0400X	Neurology Physician	01069283A	IN
4	2084N0400X	Neurology Physician	MD60315550	WA
5	2084N0400X	Neurology Physician	101251455	VA
6	2084N0400X	Neurology Physician	48167	TN
7	2084N0400X	Neurology Physician	MD445405	PA
8	2084N0400X	Neurology Physician	252383	NY
9	2084N0400X	Neurology Physician	45455	KY
10	2084N0400X	Neurology Physician	036.117626	IL
11	2084N0400X	Neurology Physician	MD-38642	IA
12	2084N0400X	Neurology Physician	ME112270	FL
13	2084N0600X	Clinical Neurophysiology Physician	MD60315550	WA
14	246ZE0600X	Electroneurodiagnostic Specialist/Technologist	MD60315550	WA
15	2084N0400X	Neurology Physician	4301068843	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	OF36369	OTHER	IL	BCBS-IL

General Provider Information

NPI Number	:	1013065879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN LINDSAY HOLLANDER M.D

Provider Business Mailing Address
First Line	:	2601 JAHN AVE NW STE A4
Second Line	:
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-8905
Country	:	US
Telephone Number	:	360-742-3538
Fax Number	:	717-674-6171

Provider Business Practice Location Address
First Line	:	1708 RIDGECREST
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-3160
Country	:	US
Telephone Number	:	815-715-2299
Fax Number	:	717-674-6171

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	10/31/2019

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