Provider Demographics
NPI:1164762167
Name:DION, SUZAN EILEEN (DO)
Entity Type:Individual
Prefix:DR
First Name:SUZAN
Middle Name:EILEEN
Last Name:DION
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SUZAN
Other - Middle Name:EILEEN
Other - Last Name:GERLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44-302 OLINA ST APT 4
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2656
Mailing Address - Country:US
Mailing Address - Phone:314-401-1577
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 327
Practice Address - Street 2:
Practice Address - City:CAMP LEJEUNE
Practice Address - State:AA
Practice Address - Zip Code:28547
Practice Address - Country:US
Practice Address - Phone:910-451-6628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA167492084P0800X
390200000X
MI5101020277171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program