Provider Demographics
NPI:1932120375
Name:COUTINHO MCALLISTER, SUSAN C (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:COUTINHO MCALLISTER
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 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:HOSPITALIST TEAM
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-3150
Practice Address - Fax:856-968-8573
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA078948207R00000X
NJ25MA07894800208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
42999OtherUNIVERSITY HEALTHPLAN
3K6231OtherHEALTHNET
NJ1383457OtherAETNA
NJ2785625000OtherAMERIHEALTH, KEYSTONE, IBC
60025736OtherHORIZON NJ HEALTH
P00396648OtherRR MEDICARE
NJ0116181Medicaid
4704218OtherCIGNA
910021371OtherAMERICHOICE
NJ0116181Medicaid