Provider Demographics
NPI:1508919317
Name:HIGGINS, SUSAN MORGAN
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MORGAN
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:MORGAN
Other - Last Name:HIGGINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D
Mailing Address - Street 1:19760 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2525
Mailing Address - Country:US
Mailing Address - Phone:301-739-2137
Mailing Address - Fax:
Practice Address - Street 1:324 E ANTIETAM ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5754
Practice Address - Country:US
Practice Address - Phone:301-766-4167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD07301OtherPHARMACIST LICENSE