MEDICARE: SUSAN MICHELLE ECHT 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	207Q00000X	Family Medicine Physician	DR.0071709	CO
2	207Q00000X	Family Medicine Physician	15398	NV

General Provider Information

NPI Number	:	1235441205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN MICHELLE ECHT M.D.

Provider Business Mailing Address
First Line	:	762 ELSTREE CT
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4560
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1607 E WINDMILL LN STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1905
Country	:	US
Telephone Number	:	702-960-4465
Fax Number	:	702-960-4468

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

Provider Enumeration Date	:	07/07/2010
Last Update Date	:	01/09/2024

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