Provider Demographics
NPI:1649400409
Name:HIGGINBOTHAM, SUZANNE KATHRYN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:KATHRYN
Last Name:HIGGINBOTHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 5TH AVE
Mailing Address - Street 2:WELLNESS AND DISEASE MANAGEMENT CENTER
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-6202
Mailing Address - Country:US
Mailing Address - Phone:412-396-2053
Mailing Address - Fax:412-396-2161
Practice Address - Street 1:1000 5TH AVE
Practice Address - Street 2:WELLNESS AND DISEASE MANAGEMENT CENTER
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-6202
Practice Address - Country:US
Practice Address - Phone:412-396-2053
Practice Address - Fax:412-396-2161
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443081183500000X
OH03329101183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist