Provider Demographics
NPI:1649365909
Name:KANTER, SUE DANZIGER (MD)
Entity type:Individual
Prefix:DR
First Name:SUE
Middle Name:DANZIGER
Last Name:KANTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:
Other - Last Name:DANZIGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 110
Mailing Address - Street 2:
Mailing Address - City:GARRETT PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20896-0110
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:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052509207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH34368Medicare UPIN