Provider Demographics
NPI:1538140546
Name:HARTMANN, SUSANNE C (MD)
Entity Type:Individual
Prefix:
First Name:SUSANNE
Middle Name:C
Last Name:HARTMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 FORBES AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5112
Mailing Address - Country:US
Mailing Address - Phone:412-232-5546
Mailing Address - Fax:412-232-5548
Practice Address - Street 1:1350 LOCUST ST
Practice Address - Street 2:SUITE G102 BUILDING C
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4738
Practice Address - Country:US
Practice Address - Phone:412-232-8494
Practice Address - Fax:412-232-8727
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD421450173000000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH88887Medicare UPIN
PA071241JJFMedicare PIN
PA071241JUMMedicare ID - Type Unspecified