Provider Demographics
NPI:1700922747
Name:TRAXLER, SUSAN G (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:G
Last Name:TRAXLER
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 1:5400 LAUREL SPRINGS PKWY
Mailing Address - Street 2:SUITE 1402
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6056
Mailing Address - Country:US
Mailing Address - Phone:678-965-0586
Mailing Address - Fax:877-500-8092
Practice Address - Street 1:5400 LAUREL SPRINGS PKWY
Practice Address - Street 2:SUITE 1402
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6056
Practice Address - Country:US
Practice Address - Phone:678-965-0586
Practice Address - Fax:877-500-8092
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052376208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics