Provider Demographics
NPI:1467465294
Name:HURSON, SUSAN B (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:B
Last Name:HURSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3301 NEW MEXICO AVE NW
Mailing Address - Street 2:SUITE 251
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3622
Mailing Address - Country:US
Mailing Address - Phone:202-362-9872
Mailing Address - Fax:202-362-9874
Practice Address - Street 1:3301 NEW MEXICO AVE NW
Practice Address - Street 2:SUITE 251
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3622
Practice Address - Country:US
Practice Address - Phone:202-362-9872
Practice Address - Fax:202-362-9874
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2008-12-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCMD19205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCF27591Medicare UPIN
DC723520Medicare PIN