Provider Demographics
NPI:1114988037
Name:BITTENBENDER, SUSAN E (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:BITTENBENDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1185 CHESTERSHIRE PL
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-9600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:410 W LINFIELD TRAPPE RD
Practice Address - Street 2:SUITE 240
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-4295
Practice Address - Country:US
Practice Address - Phone:610-495-6500
Practice Address - Fax:610-495-6558
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD064712L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2337296OtherAETNA
PA50018384OtherCAPITOL BLUE CROSS
PA0696423000OtherINDEPENDENCE BLUE CROSS
PA976079OtherHIGHMARK BLUE SHIELD
PA070017406OtherRAILROAD MEDICARE
PA2337296OtherAETNA
G76784Medicare UPIN