Basic Information
| Provider Information | |||||||||
| NPI: | 1760603492 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAMINSKI | ||||||||
| FirstName: | SUZANNE | ||||||||
| MiddleName: | BUKREY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BUKREY | ||||||||
| OtherFirstName: | SUZANNE | ||||||||
| OtherMiddleName: | LOUISE | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2304 WESVILL CT | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276070058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197826700 | ||||||||
| FaxNumber: | 9197822218 | ||||||||
| Practice Location | |||||||||
| Address1: | 2304 WESVILL CT | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276070058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197826700 | ||||||||
| FaxNumber: | 9197822218 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 08/17/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | 2008-01471 | NC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
No ID Information.