Provider Demographics
NPI:1922245570
Name:KILLENBERG, SUSAN DIAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:DIAZ
Last Name:KILLENBERG
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Gender:F
Credentials:MD
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Mailing Address - Street 1:DEPARTMENT OF PSYCHIATRY UNIVERSITY OF NC
Mailing Address - Street 2:CAMPUS BOX 7160
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:919-843-7080
Mailing Address - Fax:919-966-7225
Practice Address - Street 1:DEPARTMENT OF PSYCHIATRY UNIVERSITY OF NC
Practice Address - Street 2:CAMPUS BOX 7160
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-843-7080
Practice Address - Fax:919-966-7225
Is Sole Proprietor?:No
Enumeration Date:2009-01-17
Last Update Date:2009-01-17
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Provider Licenses
StateLicense IDTaxonomies
NC2005-010972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry