Provider Demographics
NPI:1962889485
Name:ORZELL, SUSANNAH CHATHAM (MD)
Entity type:Individual
Prefix:
First Name:SUSANNAH
Middle Name:CHATHAM
Last Name:ORZELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSANNAH
Other - Middle Name:CHATHAM
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-4123
Mailing Address - Fax:970-624-2416
Practice Address - Street 1:1400 E BOULDER ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5533
Practice Address - Country:US
Practice Address - Phone:719-364-4120
Practice Address - Fax:719-364-4121
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD477843207Y00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program