Provider Demographics
NPI:1225708530
Name:SUSAN MARIE ARCENEAUX MD INC
Entity Type:Organization
Organization Name:SUSAN MARIE ARCENEAUX MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ARCENEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-440-6759
Mailing Address - Street 1:24498 NOBOTTOM RD
Mailing Address - Street 2:
Mailing Address - City:OLMSTED TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44138-1538
Mailing Address - Country:US
Mailing Address - Phone:216-440-6759
Mailing Address - Fax:330-752-4776
Practice Address - Street 1:597 LAKE RD
Practice Address - Street 2:
Practice Address - City:CHIPPEWA LAKE
Practice Address - State:OH
Practice Address - Zip Code:44215-9665
Practice Address - Country:US
Practice Address - Phone:330-760-4776
Practice Address - Fax:330-725-4774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty