Provider Demographics
NPI:1558355131
Name:CAHILL, SUSAN L (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:CAHILL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:340 MAIN STREET
Mailing Address - Street 2:SUITE 670
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1681
Mailing Address - Country:US
Mailing Address - Phone:508-754-3566
Mailing Address - Fax:508-798-8012
Practice Address - Street 1:131 ORNAC
Practice Address - Street 2:SUITE 770
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4181
Practice Address - Country:US
Practice Address - Phone:978-369-4468
Practice Address - Fax:978-369-4213
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA74393208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3130983Medicaid
MAJ14586Medicare ID - Type Unspecified
MA3130983Medicaid