Provider Demographics
NPI:1427114149
Name:ALMUSA, SUSAN
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:ALMUSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 ARCH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1353
Mailing Address - Country:US
Mailing Address - Phone:215-561-3363
Mailing Address - Fax:215-561-3363
Practice Address - Street 1:8860 COLUMBIA 100 PKWY STE 106
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2286
Practice Address - Country:US
Practice Address - Phone:410-884-5833
Practice Address - Fax:410-884-5836
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI55151223G0001X
MD14648122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice