Individual provider · NPI-1

Dr. Susan A Chiarito, MD

Family Medicine · Vicksburg, MS

NPI number1871534008
StatusActive
Last updated in NPPESFeb 2, 2010

Details

NPI
1871534008
Entity type
Individual (NPI-1)
Name
Dr. Susan A Chiarito
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jun 9, 2006
Last updated
Feb 2, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine14065MSYes

Practice location

1901 Mission 66
Vicksburg, MS 39180-3711

Phone 601-636-8244

Mailing address

1901 Mission 66
Vicksburg, MS 39180-3711

Phone 601-636-8244

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