Berry, Susan Amelia
Berry, Susan Amelia is an individual health care provider with primary practice located at University Of Minnesota Physicians 516 Delaware Street Se, Pwb Fourth Floor, Room 4-100, Minneapolis MN 55455. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.), Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) is her primary health care specialty. Berry, Susan Amelia can be contacted via phone (612) 626-6777.Contact Information
Primary practice address
University Of Minnesota Physicians 516 Delaware Street Se, Pwb Fourth Floor, Room 4-100
Minneapolis MN 55455
Phone: (612) 626-6777
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) | 207SG0201X | 26368 | Minnesota |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 26368 | Minnesota |
Profile Details
| NPI number | 1982640264 |
|---|---|
| LBN Legal business name | Berry, Susan Amelia |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2006 |
| Last updated | Apr 20th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982640264 | NPPES |
| Minnesota | MEDICAID | 666773200 | |
| Minnesota | Other | 24479 | |
| Minnesota | MEDICAID | 0052275 | |
| Minnesota | Other | 12-24753 | |
| Minnesota | Other | 1270280 | |
| Minnesota | MEDICAID | 41184394337 | |
| Minnesota | MEDICAID | 30580800 | |
| Minnesota | Other | 1010201 | |
| Minnesota | MEDICAID | 1990358 | |
| Minnesota | Other | 100978 | |
| Minnesota | Other | 2T262BE | |
| Minnesota | Other | HP12898 |
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