Provider Demographics
NPI:1134391014
Name:SUE D KANTER MD LLC
Entity type:Organization
Organization Name:SUE D KANTER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:D
Authorized Official - Last Name:KANTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-530-0400
Mailing Address - Street 1:6410 ROCKLEDGE DR
Mailing Address - Street 2:SUITE 308
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1809
Mailing Address - Country:US
Mailing Address - Phone:301-530-0400
Mailing Address - Fax:
Practice Address - Street 1:6410 ROCKLEDGE DR
Practice Address - Street 2:SUITE 308
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1809
Practice Address - Country:US
Practice Address - Phone:301-530-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H34368Medicare UPIN
G00987Medicare PIN