person
Susan Lyn Koelliker, MD
Diagnostic Radiology Physician in Providence, Rhode Island
NPI 1841288719

Susan Lyn Koelliker is a Diagnostic Radiology Physician based in Warwick, RI and is specialized in Diagnostic Radiology. Susan Lyn Koelliker practices in Providence, RI and has the professional credentials of MD. The NPI Number for Susan Lyn Koelliker is 1841288719 and holds a License No. 154179 (Rhode Island).

The current practice location address for Susan Lyn Koelliker is 593 Eddy St, Providence, RI and can be reached out via phone at 401-444-5174 and via fax at 401-921-9212.

Location: 593 Eddy St, Providence, RI, 02886-1785
person
Provider Profile Details
NPI Number
1841288719
Provider Name
Susan Lyn Koelliker
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
593 Eddy St, Providence, RI, 02886-1785
Phone Number
401-444-5174
Fax Number
401-921-9212
Provider Enumeration Date
10/13/2005
Last Update Date
04/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
005220 01 BLUECHIP
403111 01 TUFTS
007004713 01 HOSPITAL PIN
1600203 01 UNITEDHEALTHPLANS
3199894 01 MASSMEDICAID
720053201 01 CIGNA
3199894 01 HEALTHYSTART
7004715 01 RIMEDICALASSISTANCE
000000001988 01 NHPRI
003111482 01 CT MED ASSISTANCE
008865 01 BLUESHIELD
007004715 01 MEDICARE
240171 01 RJHPILGRIM
300067448 01 RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
593 Eddy St
City
State
Zip
02903-4923
Phone Number
401-444-5174
Fax Number
401-921-9212
person
Provider Business Mailing Address Details
Address
593 Eddy St
City
State
Zip
02903-4923
Phone Number
401-444-5174
Fax Number
401-921-9212
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
154179 (Massachusetts)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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