Provider Demographics
NPI:1942439377
Name:CHATTERJEE, SUZANNA (MD)
Entity Type:Individual
Prefix:
First Name:SUZANNA
Middle Name:
Last Name:CHATTERJEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-2533
Mailing Address - Country:US
Mailing Address - Phone:479-219-9913
Mailing Address - Fax:479-219-9914
Practice Address - Street 1:2500 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-2533
Practice Address - Country:US
Practice Address - Phone:479-219-9913
Practice Address - Fax:479-219-9914
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE9311207V00000X
TN50036207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology