Provider Demographics
NPI:1093724668
Name:MAGARGEE, SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:MAGARGEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LINDENWOOD DRIVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355
Mailing Address - Country:US
Mailing Address - Phone:215-590-2897
Mailing Address - Fax:215-590-0325
Practice Address - Street 1:600 HAVERFORD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041
Practice Address - Country:US
Practice Address - Phone:610-658-1998
Practice Address - Fax:610-658-1998
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-006238-L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF02533Medicare UPIN
PA459142Medicare ID - Type Unspecified