Daniel Susanto is a Neuroradiology in Lynnwood, Washington. Daniel Susanto practices all healthcare services and medical treatments related to Neuroradiology. The NPI Number for Daniel Susanto is 1144364605. The last update date is 2019-11-05.
Daniel Susanto's current location address is 19020 33rd Ave W Ste 210, Lynnwood, Washington. You can contact this provider via phone number 4255631500 and fax number 4255631374. The mailing address for Daniel Susanto is 19020 33rd Ave W Ste 210, Lynnwood, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Daniel Susanto |
|---|---|
| Address | 19020 33rd Ave W Ste 210, Lynnwood, Washington |
| Phone Number | 4255631500 |
| Fax Number | 4255631374 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1144364605 |
|---|---|
| Provider Enumeration Date | 2007-02-17 |
| Last Updated Date | 2019-11-05 |
Provider Mailing Address Detail
| Address | 19020 33rd Ave W Ste 210 |
|---|---|
| City | Lynnwood |
| State | Washington (WA) |
| Post Code | 980364748 |
| Phone Number | 4255631500 |
| Fax Number | 4255631374 |
Provider's Primary Taxonomy Detail
| Speciality | Neuroradiology |
|---|---|
| Taxonomy | 2085N0700X |
| Licence No | MD60083485 |
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Definition: A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1144364605 | ID | -- | |
| 263299 | WA | LNI | |
| 1584895 | AK | -- | |
| 263302 | WA | LNI | |
| 263305 | WA | LNI | |
| 2007663 | WA | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Daniel Susanto by the Centers for Medicare & Medicaid Services?
The Daniel Susanto has been issued the NPI (National Provider Identifier) 1144364605. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Daniel Susanto's physical address?
The Daniel Susanto is physically located at 19020 33Rd Ave W Ste 210, in the city of Lynnwood, WA, with the postal code 980364748.
What is the Daniel Susanto's specialty and taxonomy code?
The Daniel Susanto's specialty is Neuroradiology, and the corresponding taxonomy code is 2085N0700X.
On what date did the Daniel Susanto receive the assignment of its 1144364605 from the Centers for Medicare & Medicaid Services?
The Daniel Susanto was issued its 1144364605 by the Centers for Medicare & Medicaid Services on 2007-02-17.
When was the information pertaining to Daniel Susanto most recently updated or revised?
The details related to Daniel Susanto, including its address, specialty, and other relevant information, were last updated or revised on 2019-11-05.
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