Provider Demographics
NPI:1366411621
Name:ZWIEBEL, SUSAN C (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:C
Last Name:ZWIEBEL
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 1:1865 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055
Mailing Address - Country:US
Mailing Address - Phone:220-564-4972
Mailing Address - Fax:220-564-7991
Practice Address - Street 1:1865 TAMARACK RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055
Practice Address - Country:US
Practice Address - Phone:220-564-4972
Practice Address - Fax:220-564-4991
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.085901207P00000X, 2083X0100X
OH35-085901207Q00000X
OH350859012083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2557773Medicaid
OH2557773Medicaid
OHZW4175378Medicare PIN
OHZW4157371Medicare ID - Type Unspecified