Provider Demographics
NPI:1881644268
Name:NORDIN, SUSAN Z (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:Z
Last Name:NORDIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:615 NIAGARA COURT
Mailing Address - Street 2:UMD HEALTH SERVICES
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55812-3065
Mailing Address - Country:US
Mailing Address - Phone:218-726-8155
Mailing Address - Fax:218-726-8515
Practice Address - Street 1:615 NIAGARA COURT
Practice Address - Street 2:UMD HEALTH SERVICES
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55812-3065
Practice Address - Country:US
Practice Address - Phone:218-726-8155
Practice Address - Fax:218-726-8515
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN38035207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN277024500Medicaid
MNG11189Medicare UPIN
MN277024500Medicaid