Provider Demographics
NPI:1063495802
Name:SUSSWEIN, LISA R (MS)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:R
Last Name:SUSSWEIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 WESTGREEN DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9180
Mailing Address - Country:US
Mailing Address - Phone:919-843-3158
Mailing Address - Fax:
Practice Address - Street 1:UNC CHAPEL HILL
Practice Address - Street 2:CB#7264
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7264
Practice Address - Country:US
Practice Address - Phone:919-843-3158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS