Provider Demographics
NPI:1467452052
Name:STEPANSKI, SUZANNE M (MD)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:M
Last Name:STEPANSKI
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 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:2407 REICHART RD
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-8969
Practice Address - Country:US
Practice Address - Phone:570-784-8303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015842207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI194L8STOtherATRIUM COMMERCIAL
WI2115052OtherFIRST HEALTH
WI5072OtherMMSI
WIP00184725OtherRAILROAD-MEDICARE ELROY
WIP00051176OtherRAILROAD MEDICARE - HILLS
MN194L8STOtherMINNESOTA BCBS
WI39092953818OtherUNITY ELROY CLINIC
WI43507300Medicaid
WI39092953819OtherUNITY - HILLSBORO CLINIC
WI4120042P01OtherCIGNA
WI1042944OtherPHYSICIANS PLUS
WI13474OtherDEAN HEALTH PLAN
WIHP67024OtherHEALTH PARTNERS
WIHP67024OtherHEALTH PARTNERS
WI0005Medicare ID - Type UnspecifiedFACILITY 000031005
WI43507300Medicaid