Susan Spevack Carlson, MD
Individual provider Active NPI Family Medicine Physician · Sitka, AK
NPI 1932200946 · NPPES record last updated Jan 7, 2008
Key facts
- NPI
- 1932200946
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 1759 (AK)
- Practice address
- 222 Shotgun Alley
Sitka, AK 99835-1867 - Phone
- (907) 747-6474
- NPI assigned
- Sep 25, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1759 | AK | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1759 | AK | Yes |
Addresses
Primary practice location
222 Shotgun Alley
Sitka, AK 99835-1867
Mailing address
PO Box 1867
Sitka, AK 99835-1867
Phone (907) 747-6474
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD1759 | Medicaid | AK |
Other providers in Sitka, AK
- Morgan Priscilla Capobianco
- Kimberly Christine Capp
- Chanel Dallas Carbillon
- Morgan R Carlson
- Robert Howard Carlson
- Kathy Mary Carlton
- Kelsey Carney
- Susan Carpenter
- Patrick Louis Carrico
- Katherine Elizabeth Carroll
All providers in Sitka, AK · Family Medicine Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2008. 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.