Provider Demographics
NPI:1669423950
Name:HECHT, SUZANNE S (MD)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:S
Last Name:HECHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:SCHEIBENGRABER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:720 WASHINGTON AVE SE
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414
Mailing Address - Country:US
Mailing Address - Phone:612-884-0649
Mailing Address - Fax:
Practice Address - Street 1:2512 SOUTH 7TH STREET, FIRST FLOOR, R102
Practice Address - Street 2:UNIVERSITY ORTHOPEADICS
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1404
Practice Address - Country:US
Practice Address - Phone:612-884-0649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83993207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG83993FMedicare ID - Type UnspecifiedMEDICARE PPIN
CAWG83993EMedicare ID - Type UnspecifiedMEDICARE PPIN
F93857Medicare UPIN