Provider Demographics
NPI:1487685723
Name:WARMUS, SUSAN STEPHANIE (PA-SURGERY)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:STEPHANIE
Last Name:WARMUS
Suffix:
Gender:F
Credentials:PA-SURGERY
Other - Prefix:MS
Other - First Name:SUSIE
Other - Middle Name:STEPHANIE
Other - Last Name:WARMUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-SURGERY
Mailing Address - Street 1:PO BOX 40760
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85274
Mailing Address - Country:US
Mailing Address - Phone:480-706-9430
Mailing Address - Fax:480-706-1285
Practice Address - Street 1:2852 S CARRIAGE LANE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202
Practice Address - Country:US
Practice Address - Phone:480-706-9430
Practice Address - Fax:480-706-1285
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical