Provider Demographics
NPI:1689718173
Name:COBLE, SUZANNE (MD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:COBLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 ROXBURY ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3857
Mailing Address - Country:US
Mailing Address - Phone:603-357-9959
Mailing Address - Fax:603-357-9758
Practice Address - Street 1:93 ROXBURY ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3857
Practice Address - Country:US
Practice Address - Phone:603-357-9959
Practice Address - Fax:603-357-9758
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G10925Medicare UPIN
RE3640Medicare ID - Type Unspecified