Provider Demographics
NPI:1801910948
Name:DONNELLY, SUSAN MARGARET (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARGARET
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3 HAYLOFT CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1934
Mailing Address - Country:US
Mailing Address - Phone:302-498-6304
Mailing Address - Fax:302-235-8682
Practice Address - Street 1:5301 LIMESTONE RD STE 103
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1251
Practice Address - Country:US
Practice Address - Phone:302-498-6304
Practice Address - Fax:302-234-8682
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10003454207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology