Provider Demographics
NPI:1902861065
Name:JONAS, SUSAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:K
Last Name:JONAS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:J30 OMEGA DRIVE
Mailing Address - Street 2:OMEGA PROF CTR
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2083
Mailing Address - Country:US
Mailing Address - Phone:302-454-0362
Mailing Address - Fax:302-456-9424
Practice Address - Street 1:J30 OMEGA DRIVE
Practice Address - Street 2:OMEGA PROF CTR
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2083
Practice Address - Country:US
Practice Address - Phone:302-454-0362
Practice Address - Fax:302-456-9424
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC10002323207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000081102Medicaid
DE439983Medicare ID - Type Unspecified
DE0000081102Medicaid