Provider Demographics
NPI:1568693331
Name:PANNY, SUSAN ROSEANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:ROSEANNE
Last Name:PANNY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:400 SYMPHONY CIRCLE
Mailing Address - Street 2:# 425
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21030-2054
Mailing Address - Country:US
Mailing Address - Phone:410-329-1995
Mailing Address - Fax:410-329-1995
Practice Address - Street 1:201 W PRESTON ST
Practice Address - Street 2:SUITE 424
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-2301
Practice Address - Country:US
Practice Address - Phone:410-767-6730
Practice Address - Fax:410-333-5047
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
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Provider Licenses
StateLicense IDTaxonomies
MDD0026746207SG0201X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics