Provider Demographics
NPI:1952662710
Name:CHOE, SUSAN (DO)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:CHOE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PROVIDER ENROLLMENT DEPT. LAHEY CLINIC INC
Mailing Address - Street 2:41 MALL ROAD
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8085
Mailing Address - Fax:
Practice Address - Street 1:LAHEY OUTPATIENT CENTER @ DANVERS
Practice Address - Street 2:480 MAPLE STREET 1ST FL
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923
Practice Address - Country:US
Practice Address - Phone:978-304-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA272770207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism