Provider Demographics
NPI:1316077001
Name:KUSSMAUL, SUSANNAH CHAMIE (MD)
Entity type:Individual
Prefix:DR
First Name:SUSANNAH
Middle Name:CHAMIE
Last Name:KUSSMAUL
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Gender:F
Credentials:MD
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Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:SUMC - PEDIATRICS PHYSICIAN BILLING, MC:5530
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-498-7391
Mailing Address - Fax:650-725-7888
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:SUMC - PEDIATRICS PHYSICIAN BILLING, MC:5530
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-498-7391
Practice Address - Fax:650-725-7888
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2021-12-14
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Provider Licenses
StateLicense IDTaxonomies
CAA98826208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics