Provider Demographics
NPI:1841631579
Name:OVERKAMP, SUSAN MARIE (DO)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARIE
Last Name:OVERKAMP
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:15 KIPLING WAY APT 103
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-8120
Mailing Address - Country:US
Mailing Address - Phone:314-359-3151
Mailing Address - Fax:314-293-6781
Practice Address - Street 1:201 W BROADWAY STE 5B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3842
Practice Address - Country:US
Practice Address - Phone:314-359-3151
Practice Address - Fax:314-293-6781
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2025-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2014006558207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine