Provider Demographics
NPI:1215919782
Name:MCLAUGHLIN, SUZANNE E (MD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:E
Last Name:MCLAUGHLIN
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 1:593 EDDY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4923
Mailing Address - Country:US
Mailing Address - Phone:401-444-6118
Mailing Address - Fax:401-444-6378
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:POB-224 MED/PEDS CLINIC
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-6118
Practice Address - Fax:401-444-8804
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD12823207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007060792Medicare PIN