Provider Demographics
NPI:1831182658
Name:CARPENTER, SUSAN ELLEN (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ELLEN
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 CONCOURSE PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-6278
Mailing Address - Country:US
Mailing Address - Phone:678-597-9933
Mailing Address - Fax:678-726-8183
Practice Address - Street 1:6 CONCOURSE PKWY STE 250
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-6278
Practice Address - Country:US
Practice Address - Phone:678-597-9933
Practice Address - Fax:678-726-8183
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA037502207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology