Edward Bart Sussman, M.D.
Individual provider Active NPI Forensic Pathology Physician · Chilmark, MA
NPI 1659604510 · NPPES record last updated Sep 10, 2009
Key facts
- NPI
- 1659604510
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Forensic Pathology Physician 207ZF0201X
- License
- 39001 (MA)
- Practice address
- 3 Cove Road Studio
Chilmark, MA 02535-0308 - Phone
- (508) 645-3005
- Fax
- (508) 645-2250
- NPI assigned
- Sep 10, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39001 | MA | MD | Forensic Pathology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Pathology Physician | 207ZF0201X | 39001 | MA | Yes |
Addresses
Primary practice location
3 Cove Road Studio
Chilmark, MA 02535-0308
Mailing address
3 Cove Road Studio
Chilmark, MA 02535-0308
Phone (508) 645-3005
Other providers in Chilmark, MA
- Elizabeth Gregg
- Inner Journey Wellness PC
- Lifeguard Medical Group, LLC
- Linda S McCarthy
- Thomas Redner
- Town of Chilmark
All providers in Chilmark, MA · Forensic Pathology Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.