Mccullum, Susan D

Mccullum, Susan D is an individual health care provider with primary practice located at 2232 Grand Ave , Fort Myers FL 33901-3717. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mccullum, Susan D can be contacted via phone (239) 344-2341.

Contact Information

Primary practice address
2232 Grand Ave Fort Myers FL 33901-3717
Phone: (239) 344-2341
Fax: (239) 334-7518
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME86366 Florida

Profile Details

NPI number 1578554291
LBN Legal business name Mccullum, Susan D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Apr 30th, 2010 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578554291 NPPES
Florida MEDICAID 265855100
Florida Other 7768378
Florida Other 1483313
Florida Other 62808

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