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NPI Code Detail

MEDICARE: SUSAN ERMER M.D.

MEDICARE: SUSAN ERMER 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 Physician39704TN

General Provider Information

NPI Number : 1316946965
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN ERMER M.D.
Provider Business Mailing Address
First Line : 435 25TH ST NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3838
Country : US
Telephone Number : 423-479-9733
Fax Number :
Provider Business Practice Location Address
First Line : 435 25TH ST NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3838
Country : US
Telephone Number : 423-479-9733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2005
Last Update Date : 08/18/2011

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