Provider Demographics
NPI:1306013321
Name:KNOCHE, SUSAN GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:GEORGE
Last Name:KNOCHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:295A MIDLAND PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-5901
Mailing Address - Country:US
Mailing Address - Phone:843-695-2727
Mailing Address - Fax:843-695-2728
Practice Address - Street 1:295A MIDLAND PKWY STE 140
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-5901
Practice Address - Country:US
Practice Address - Phone:843-695-2727
Practice Address - Fax:843-695-2728
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC82253208C00000X, 208600000X
MI4301108743208C00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery