Provider Demographics
NPI:1912974478
Name:GINSBERG, SUSAN MERL (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MERL
Last Name:GINSBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:MERL
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14217 NORTHWYN DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5931
Mailing Address - Country:US
Mailing Address - Phone:301-509-1120
Mailing Address - Fax:202-726-8076
Practice Address - Street 1:1201 SEVEN LOCKS RD STE 200
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20854
Practice Address - Country:US
Practice Address - Phone:301-907-3939
Practice Address - Fax:301-656-3943
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD12879207RN0300X
MDD0026564207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD436191100Medicaid
DC026952200Medicaid