Provider Demographics
NPI:1972728855
Name:BEGELMAN, SUSAN MERRILL (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MERRILL
Last Name:BEGELMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:388 BEALE ST
Mailing Address - Street 2:APT 808
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-4401
Mailing Address - Country:US
Mailing Address - Phone:415-904-9810
Mailing Address - Fax:650-517-8069
Practice Address - Street 1:388 BEALE ST
Practice Address - Street 2:APT 808
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-4401
Practice Address - Country:US
Practice Address - Phone:415-904-9810
Practice Address - Fax:650-517-8069
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-3311-B207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2177371Medicaid