Basic Information
Provider Information
NPI: 1083664684
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOPALIAN
FirstName: SUZANNE
MiddleName: LOUISE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 64563
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212644563
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 600 N WOLFE ST
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212870005
CountryCode: US
TelephoneNumber: 4109556796
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/12/2006
LastUpdateDate: 10/06/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XD64359MDY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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