Provider Demographics
NPI:1306484902
Name:HUGUENIN, SUZETTE MARIE (PHD)
Entity type:Individual
Prefix:
First Name:SUZETTE
Middle Name:MARIE
Last Name:HUGUENIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SUZETTE
Other - Middle Name:MARIE
Other - Last Name:HUGUENIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:KENNEDY KRIEGER INSTITUTE
Mailing Address - Street 2:707 N BROADWAY RM 526
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-1832
Mailing Address - Country:US
Mailing Address - Phone:443-923-2782
Mailing Address - Fax:443-923-2781
Practice Address - Street 1:KENNEDY KRIEGER INSTITUTE
Practice Address - Street 2:707 N BROADWAY RM 526
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-1832
Practice Address - Country:US
Practice Address - Phone:443-923-2782
Practice Address - Fax:443-923-2781
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2005072B207SG0202X
DC2005072W207SG0203X
170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
No207SG0202XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Biochemical Genetics
No207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics