Kenneth Sussman, is a
Pediatrics physician based in Virginia, Minnesota. Kenneth Sussman is licensed to practice in Minnesota (license number 22447) and his current practice location is 1101 9th St N, Virginia, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(218) 741-0150.
NPI number for Kenneth Sussman is 1134226236 and his current mailing address is 400 E 3rd St, Duluth, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1134226236.
Physician's Profile
| Full Name | Kenneth Sussman |
|---|
| Gender | Male |
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| Speciality | Pediatrics |
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| Location | 1101 9th St N, Virginia, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1134226236
- Provider Enumeration Date: 09/20/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Kenneth Sussman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1134226236 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 22447 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Sussman is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kenneth Sussman,
400 E 3rd St,
Duluth, MN 55805-1951
Ph: (218) 786-8364 | Kenneth Sussman,
1101 9th St N,
Virginia, MN 55792-2329
Ph: (218) 741-0150 |
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