MEDICARE: MS. SUSAN E WALTHER M.S., C.G.C.

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	170300000X	Genetic Counselor (M.S.)	GC000134	PA

General Provider Information

NPI Number	:	1497893846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN E WALTHER M.S., C.G.C.

Provider Business Mailing Address
First Line	:	200 FORREST AVE
Second Line	:
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-1918
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 500
Second Line	:
City	:	INTERCOURSE
State	:	PA
Zip	:	17534-0500
Country	:	US
Telephone Number	:	717-687-9407
Fax Number	:	717-687-9237

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

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	04/23/2025

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