Susan H Andersen, MD

Individual provider Active NPI Pediatrics Physician · Wilson, NC

NPI 1891875340 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1891875340
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
32333 (NC)
Practice address
1702 Medical Park Dr W
Wilson, NC 27893-2705
Phone
(252) 243-7944
Fax
(252) 243-6097
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

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

LicenseStateTypeSpecialty
32333NCMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: drandersen@easterncarolinapediatrics.opdirect.net

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 32333 NC Yes

Addresses

Primary practice location

1702 Medical Park Dr W
Wilson, NC 27893-2705

Mailing address

1702 Medical Park Dr W
Wilson, NC 27893-2705
Phone (252) 243-7944

Other identifiers

IdentifierTypeStateIssuer
8911095MedicaidNC

Other names

  • Dr. Susan H Andersen Professional name

Other providers in Wilson, NC

All providers in Wilson, NC · Pediatrics Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.