Provider Demographics
NPI:1215991450
Name:MARTIN, SUSAN THRASHER (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:THRASHER
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:102 BUFORD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-3365
Mailing Address - Country:US
Mailing Address - Phone:864-261-9506
Mailing Address - Fax:864-226-4201
Practice Address - Street 1:102 BUFORD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:864-261-9506
Practice Address - Fax:864-226-4201
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15577207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC155771Medicaid
E98100Medicare UPIN