Provider Demographics
NPI:1528016474
Name:MCGUIRE, SUSAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:K
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37422-2487
Mailing Address - Country:US
Mailing Address - Phone:423-648-4951
Mailing Address - Fax:423-490-0410
Practice Address - Street 1:6400 LEE HWY
Practice Address - Street 2:ST 110
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2452
Practice Address - Country:US
Practice Address - Phone:423-648-4951
Practice Address - Fax:423-490-0410
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN135982084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB04756Medicare UPIN
TN3197555Medicare ID - Type Unspecified