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NPI Code Detail

MEDICARE: SUSAN DUDDY MARTIN M.D.

MEDICARE:   SUSAN DUDDY MARTIN  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
1208000000XPediatrics Physician46871KY
2207LP3000XPediatric Anesthesiology Physician289015NY
3390200000XStudent in an Organized Health Care Education/Training Program
42080P0203XPediatric Critical Care Medicine Physician289015NY

General Provider Information

NPI Number : 1184923351
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN DUDDY MARTIN M.D.
Provider Business Mailing Address
First Line : 601 ELMWOOD AVE BOX 635
Second Line :
City : ROCHESTER
State : NY
Zip : 14642-0001
Country : US
Telephone Number : 585-275-8138
Fax Number : 585-276-1128
Provider Business Practice Location Address
First Line : 601 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14642-0001
Country : US
Telephone Number : 585-275-8138
Fax Number : 585-276-1128
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2011
Last Update Date : 06/29/2023

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Directions to “ SUSAN DUDDY MARTIN M.D.” Practice Location

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