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NPI Code Detail

MEDICARE: SUSANNE MICHELLE HAFIZ LAC

MEDICARE:   SUSANNE MICHELLE HAFIZ  LAC
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
1171100000XAcupuncturistUO1109MD

General Provider Information

NPI Number : 1932322492
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSANNE MICHELLE HAFIZ LAC
Provider Business Mailing Address
First Line : 62 BRYANS MILL WAY
Second Line :
City : CATONSVILLE
State : MD
Zip : 21228-5454
Country : US
Telephone Number : 410-440-6993
Fax Number : 410-418-8778
Provider Business Practice Location Address
First Line : 8388 COURT AVE STE 101
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21043-4514
Country : US
Telephone Number : 410-418-8840
Fax Number : 410-418-8778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 07/08/2007

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Directions to “ SUSANNE MICHELLE HAFIZ LAC” Practice Location

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