Provider Demographics
NPI:1770161358
Name:FARRIS, SUZAN REBEKAH (MD)
Entity type:Individual
Prefix:DR
First Name:SUZAN
Middle Name:REBEKAH
Last Name:FARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:166 MERRIMONT DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-4931
Mailing Address - Country:US
Mailing Address - Phone:336-250-3327
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-2317
Practice Address - Fax:336-716-2810
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRTL21-08602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology