Provider Demographics
NPI:1750583092
Name:KNOWLES, SUSAN L (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:897 IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-5198
Mailing Address - Country:US
Mailing Address - Phone:775-782-1610
Mailing Address - Fax:775-782-2310
Practice Address - Street 1:897 IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-5198
Practice Address - Country:US
Practice Address - Phone:775-782-1610
Practice Address - Fax:775-782-2310
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2025-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV14138207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1184601239Medicaid
NVVWQBHVMedicare PIN