Provider Demographics
NPI:1669431011
Name:SOLOMON, SUSAN HOWELL (DC)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:HOWELL
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:HOWELL
Other - Last Name:SOLOMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:568 SAVANNAH HWY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7210
Mailing Address - Country:US
Mailing Address - Phone:843-577-5793
Mailing Address - Fax:843-722-8244
Practice Address - Street 1:568 SAVANNAH HWY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7210
Practice Address - Country:US
Practice Address - Phone:843-577-5793
Practice Address - Fax:843-722-8244
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU789956667Medicare UPIN
SC6667Medicare ID - Type Unspecified