Provider Demographics
NPI:1619506193
Name:SUSKIN, ZAEV DAVID (MD, MBE)
Entity Type:Individual
Prefix:DR
First Name:ZAEV
Middle Name:DAVID
Last Name:SUSKIN
Suffix:
Gender:M
Credentials:MD, MBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 SPALDING RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-4700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:819 N 1ST ST
Practice Address - Street 2:
Practice Address - City:DENNISON
Practice Address - State:OH
Practice Address - Zip Code:44621-1003
Practice Address - Country:US
Practice Address - Phone:740-922-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA94619207P00000X, 208D00000X
OK35900207P00000X
390200000X
OH35.150405207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK35900OtherMEDICAL LICENSE
GA94619OtherMEDICAL LICENSE
OH35.150405OtherMEDICAL LICENSE