Provider Demographics
NPI:1538276175
Name:JAMES, SUSAN B (DO)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:B
Last Name:JAMES
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 1:46 OBERY ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2130
Mailing Address - Country:US
Mailing Address - Phone:508-833-3999
Mailing Address - Fax:
Practice Address - Street 1:441 ROUTE 130
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-2340
Practice Address - Country:US
Practice Address - Phone:508-833-3999
Practice Address - Fax:508-833-3917
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220278207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2079798Medicaid
MAI15170Medicare UPIN
MAA37554Medicare ID - Type Unspecified