MEDICARE: DR. SUSAN MARIE ARCENEAUX 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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	35063143	OH
2	208100000X	Physical Medicine & Rehabilitation Physician	35-063143	OH

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

General Provider Information

NPI Number	:	1316915085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN MARIE ARCENEAUX M.D.

Provider Business Mailing Address
First Line	:	24498 NOBOTTOM RD
Second Line	:
City	:	OLMSTED TWP
State	:	OH
Zip	:	44138-1538
Country	:	US
Telephone Number	:	216-440-6759
Fax Number	:	330-725-0054

Provider Business Practice Location Address
First Line	:	597 LAKE RD
Second Line	:
City	:	CHIPPEWA LAKE
State	:	OH
Zip	:	44215-9665
Country	:	US
Telephone Number	:	330-760-4776
Fax Number	:	330-725-0054

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	07/11/2022

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