Provider Demographics
NPI:1770922072
Name:JOHN, SUZANA ALEX (MD)
Entity type:Individual
Prefix:
First Name:SUZANA
Middle Name:ALEX
Last Name:JOHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:247 WHITEHEAD BIOMEDICAL RESEARCH BLDG 615 MICHAEL ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-0001
Mailing Address - Country:US
Mailing Address - Phone:404-712-2945
Mailing Address - Fax:
Practice Address - Street 1:247 WHITEHEAD BIOMEDICAL RESEARCH BLDG 615 MICHAEL ST
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-712-2945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA080734207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology