DR. Kenneth M Sussman, M.D.

NPI #1194888065 in Dacula, Georgia

Provider Information

NPI Number: 1194888065
Entity Type: Individual
Name: DR. Kenneth M Sussman, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Obstetrics & Gynecology
Credential: M.D.
Enumeration Date: Dec 19, 2006
Last Updated: Jul 9, 2007

Practice Location

Address: 768 GLEN VALLEY WAY
City: Dacula
State: Georgia
ZIP Code: 30019-4878
Phone: (770) 513-3990

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X	Primary

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