Provider Demographics
NPI:1174579817
Name:WEEKS, SUSAN MARIE (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARIE
Last Name:WEEKS
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 1:6812 UNION GROVE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-7408
Mailing Address - Country:US
Mailing Address - Phone:919-932-3445
Mailing Address - Fax:
Practice Address - Street 1:6812 UNION GROVE CHURCH RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-7408
Practice Address - Country:US
Practice Address - Phone:919-932-3445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96-015182085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6921201OtherCIGNA
NC891000XMedicaid
NC1000XOtherBLUECROSS BLUESHIELD
NC1000XOtherBLUECROSS BLUESHIELD
G37686Medicare UPIN