Provider Demographics
NPI:1467524181
Name:CLARE, SUZANNE (DC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:CLARE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:CLARE
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3328 GUESS RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2158
Mailing Address - Country:US
Mailing Address - Phone:919-477-6330
Mailing Address - Fax:919-477-3969
Practice Address - Street 1:3328 GUESS RD STE 1A
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2158
Practice Address - Country:US
Practice Address - Phone:919-477-6330
Practice Address - Fax:919-477-3969
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2831111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085E4OtherBCBS
NCV04460Medicare UPIN
NC2457574Medicare ID - Type Unspecified