Provider Demographics
NPI:1447646013
Name:PLATT, SUSIE WANG (DO, MPH, MAJ)
Entity type:Individual
Prefix:
First Name:SUSIE
Middle Name:WANG
Last Name:PLATT
Suffix:
Gender:F
Credentials:DO, MPH, MAJ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 936857
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6857
Mailing Address - Country:US
Mailing Address - Phone:910-662-7500
Mailing Address - Fax:910-662-7501
Practice Address - Street 1:1509 DOCTORS CIR BLDG C
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7403
Practice Address - Country:US
Practice Address - Phone:910-662-7500
Practice Address - Fax:910-662-7501
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE#1508208D00000X
FLOS192102084N0400X
NC2021-013002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice