Provider Demographics
NPI:1326215211
Name:THEUT, SUSAN KATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:KATHERINE
Last Name:THEUT
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 1:2114 HUIDEKOPER PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1822
Mailing Address - Country:US
Mailing Address - Phone:202-338-8034
Mailing Address - Fax:202-338-8157
Practice Address - Street 1:2114 HUIDEKOPER PL NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-1822
Practice Address - Country:US
Practice Address - Phone:202-338-8034
Practice Address - Fax:202-338-8157
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-11
Last Update Date:2008-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD167482084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry