Provider Demographics
NPI:1174631881
Name:WERTHEIMER, SUZANNE L (MD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:L
Last Name:WERTHEIMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 723
Mailing Address - Street 2:
Mailing Address - City:HYANNIS PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02647-0723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:VA HYANNIS PRIMARY CARE
Practice Address - Street 2:145 FALMOUTH RD
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02610
Practice Address - Country:US
Practice Address - Phone:508-771-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2235202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry