Provider Demographics
NPI:1194025833
Name:LOW, SUZANNE GH
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:GH
Last Name:LOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6209 LAKESHORE DR.
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-7753
Mailing Address - Country:US
Mailing Address - Phone:715-359-0299
Mailing Address - Fax:715-355-2159
Practice Address - Street 1:6209 LAKESHORE DR.
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-7753
Practice Address - Country:US
Practice Address - Phone:715-359-0299
Practice Address - Fax:715-355-2159
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20469-020207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology