Provider Demographics
NPI:1538263215
Name:HAROLD, SUZANNE MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MICHELLE
Last Name:HAROLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUZANNE
Other - Middle Name:MICHELLE
Other - Last Name:BRECKENRIDGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4634 HILLS AND DALES RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1510
Mailing Address - Country:US
Mailing Address - Phone:330-477-0255
Mailing Address - Fax:
Practice Address - Street 1:4634 HILLS AND DALES RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1510
Practice Address - Country:US
Practice Address - Phone:330-477-0255
Practice Address - Fax:330-477-7266
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH88128207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism