Provider Demographics
NPI:1972656759
Name:EPPES, SUSAN BENNETT (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:BENNETT
Last Name:EPPES
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 1:8 WABAN RD STE 340
Mailing Address - Street 2:
Mailing Address - City:TIMBERLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44095-1952
Mailing Address - Country:US
Mailing Address - Phone:216-926-6963
Mailing Address - Fax:
Practice Address - Street 1:3401 ENTERPRISE PKWY STE 340
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7340
Practice Address - Country:US
Practice Address - Phone:216-926-6963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0884572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry