Provider Demographics
NPI:1104846203
Name:MCDONALD, SUSAN IRENE (CNM)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:IRENE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:CNM
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Other - First Name:
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Mailing Address - Street 1:3555 CESAR CHAVEZ
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4403
Mailing Address - Country:US
Mailing Address - Phone:415-641-2177
Mailing Address - Fax:415-641-2190
Practice Address - Street 1:1580 VALENCIA ST STE 508
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4415
Practice Address - Country:US
Practice Address - Phone:415-641-2177
Practice Address - Fax:415-641-2190
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CANMW963367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife