Provider Demographics
NPI:1811925084
Name:RELF, SUSAN J (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:RELF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5007 MATTERHORN DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-3812
Mailing Address - Country:US
Mailing Address - Phone:218-720-3553
Mailing Address - Fax:218-786-9375
Practice Address - Street 1:5007 MATTERHORN DR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-3812
Practice Address - Country:US
Practice Address - Phone:218-720-3553
Practice Address - Fax:218-786-9375
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN32739207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNF35882Medicare UPIN