Provider Demographics
NPI:1649352535
Name:PELUSO, SUSAN LINDA (PHP MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LINDA
Last Name:PELUSO
Suffix:
Gender:F
Credentials:PHP MD
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Mailing Address - Street 1:550 STANTON-CHRISTIANA RD SUITE 301
Mailing Address - Street 2:WHITE CLAY CREEK MEDICAL CENTER
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:302-998-4924
Mailing Address - Fax:302-998-4904
Practice Address - Street 1:550 STANTON-CHRISTIANA RD SUITE 301
Practice Address - Street 2:WHITE CLAY CREEK MEDICAL CENTER
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-998-4924
Practice Address - Fax:302-998-4904
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2008-02-13
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Provider Licenses
StateLicense IDTaxonomies
DEC10005321207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
O43698681OtherCIGNA
O43698681OtherTRI-CARE
O68446883OtherBCBS OF DELAWARE
43698681OtherUNITED HEALTHCARE
O43698681OtherMID-ATLANTIC
180637OtherCOVENTRY
642624OtherBCBS OF PA
8103356OtherMAMSI
O43698681OtherAETNA
O68446883OtherGREAT WEST
DEOOO1050501Medicaid
O43698681OtherTRI-CARE
DEOOO1050501Medicaid