Provider Demographics
NPI:1710940739
Name:DAPO, SUZANNE N (PA)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:N
Last Name:DAPO
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1771 TATE BLVD SE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4249
Mailing Address - Country:US
Mailing Address - Phone:828-324-4804
Mailing Address - Fax:828-324-7256
Practice Address - Street 1:1041 MORGANTON BLVD SW
Practice Address - Street 2:SUITE 101
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5605
Practice Address - Country:US
Practice Address - Phone:828-754-3988
Practice Address - Fax:828-754-7832
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2008-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2765932Medicare PIN
NCQ66086Medicare UPIN