Provider Demographics
NPI:1659321743
Name:HURT, SUSAN C (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:HURT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3200 DOWNWOOD CIR NW
Mailing Address - Street 2:SUITE 640
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-1610
Mailing Address - Country:US
Mailing Address - Phone:404-351-0051
Mailing Address - Fax:404-351-0632
Practice Address - Street 1:3200 DOWNWOOD CIR NW
Practice Address - Street 2:SUITE 640
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-1610
Practice Address - Country:US
Practice Address - Phone:404-351-0051
Practice Address - Fax:404-351-0632
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2011-03-22
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Provider Licenses
StateLicense IDTaxonomies
GA027832207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP2029Medicare PIN