Provider Demographics
NPI:1104288240
Name:NORTHRUP, SUSAN ELIZABETH (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:NORTHRUP
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Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:1701 COLUMBIA AVE
Mailing Address - Street 2:FEDERAL AVIATION ADMINISTRATION, ASO-300
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30337-2714
Mailing Address - Country:US
Mailing Address - Phone:404-305-6150
Mailing Address - Fax:404-305-6161
Practice Address - Street 1:1701 COLUMBIA AVENUE
Practice Address - Street 2:FEDERAL AVIATION ADMINISTRATION, ASO-300
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30337
Practice Address - Country:US
Practice Address - Phone:404-305-6150
Practice Address - Fax:404-305-6161
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
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Provider Licenses
StateLicense IDTaxonomies
GA544262083A0100X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine