Provider Demographics
NPI:1366622599
Name:GOUCHER, SUZANNE (DO)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:GOUCHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 WISCONSIN AVE INTERNAL MEDICINE CLINIC TEAM A
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0001
Mailing Address - Country:US
Mailing Address - Phone:301-295-8566
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE INTERNAL MEDICINE CLINIC TEAM A
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-3017
Practice Address - Country:US
Practice Address - Phone:301-295-8566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDO034238207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine