Provider Demographics
NPI:1053381921
Name:GARWOOD, SUSAN RENEE (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:RENEE
Last Name:GARWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:R
Other - Last Name:GARWOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:200 MEDICAL PARK DR STE 400
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-0939
Mailing Address - Country:US
Mailing Address - Phone:704-786-1108
Mailing Address - Fax:704-782-1826
Practice Address - Street 1:200 MEDICAL PARK DR STE 400
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-0939
Practice Address - Country:US
Practice Address - Phone:704-786-1108
Practice Address - Fax:704-782-1826
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32702207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCEFFOtherCIGNA HEALTHCARE
NC4378353OtherAETNA
NC5859OtherPARTNERS MEDICARE CHOICE
NC440004085OtherRAILROAD MEDICARE
NCC2464OtherMEDCOST
NC8934773Medicaid
NC34773OtherBCBSNC
NCC2464OtherMEDCOST