Provider Demographics
NPI:1417032335
Name:FLETCHER, SUZANNE MARGUERITE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MARGUERITE
Last Name:FLETCHER
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 1:6326 CANTERBURY CLOSE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4870
Mailing Address - Country:US
Mailing Address - Phone:615-371-9616
Mailing Address - Fax:
Practice Address - Street 1:TENNESSEE REHABILITATION CENTER
Practice Address - Street 2:460 NINTH AVENUE
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-2010
Practice Address - Country:US
Practice Address - Phone:615-459-6811
Practice Address - Fax:615-459-0371
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD13936207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA97443Medicare UPIN