SUSAN C NOBLE (NPI# 1770692873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770692873 |
| Entity Type | Individual |
| Full Name | SUSAN C NOBLE |
| Credential | M.D. |
| Practice Address |
550 Munson Avenue, Suite 200 Traverse City MI 49686 |
| Practice Telephone | 2319358717 |
| Practice Fax Number | 2319359230 |
| Mailing Telephone | 2319358717 |
| Mailing Fax Number | 2319359230 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2013-06-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 4301406284 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | PRIORITY HEALTH | 38-2170687 | 01 |
| MI | 1997138 | 05 | |
| MI | RAILROAD MEDICARE | 070002527 | 01 |
| MI | BLUE CROSS BLUE SHIELD | 0702821712 | 01 |
| MI | TRICARE | M008816 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992158026 | Susan Cole Noble | Counselor | 5002 Prytania Street, New Orleans, LA 70115 | 2016-07-13 |
| 1720011521 | Susan Carla Dahlberg Noble | Anesthesiology | 437 Nw Wa Na Pa St, Cascade Locks, OR 97014-7014 | 2006-07-08 |
| 1386642213 | Susan Jane Noble | Dentist | 540 Main St, Prince Frederick, MD 20678-3346 | 2005-07-13 |
| 1740758051 | Susan Noble | Dietitian, Registered | 5251 Concourse Dr, Roanoke, VA 24019-3081 | 2018-11-05 |
| 1770890279 | Susan Elvira Noble | Registered Nurse | 1380 Howard St, 2nd Floor, Room 211, San Francisco, CA 94103-2638 | 2010-09-03 |
| Street Address |
550 MUNSON AVENUE, SUITE 200 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245877208 | Jessica Marie Glowacki | Behavior Technician | 935 Hemlock St, Traverse City, MI 49686 | 2019-12-09 |
| 1568011542 | Joanne Kressley | Technician | 1693 Maylane Apt. 104, Traverse City, MI 49686 | 2019-09-11 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1245749225 | Margaret Anne Goss | Speech-Language Pathologist | 1105 E. Eighth Street, Traverse City, MI 49686 | 2017-09-22 |
| 1467981811 | Joan Joyce Shirilla | Social Worker | 2124 Twin Eagles Dr, Traverse City, MI 49686 | 2017-06-08 |
| 1770028763 | Rehab and Mobility Systems, LLC | Durable Medical Equipment & Medical Supplies | 707 Parsons, Traverse City, MI 49686 | 2016-12-29 |
| 1629511316 | Kaitlyn Grangood | Social Worker | 415 Munson Avenue, Ste 101, Traverse City, MI 49686 | 2016-11-29 |
| 1811441132 | Jeffrey D Goodwin | Counselor | 430 Fair St., Traverse City, MI 49686 | 2016-08-04 |
| 1053779918 | Thomas Osborne | Counselor | 2014 Phelps Rd., Traverse City, MI 49686 | 2016-02-08 |
| 1982079588 | Marsha Lynne Dallas | Counselor | 2240 South Airport Road, Traverse City, MI 49686 | 2015-12-08 |
| Find all providers in zip 49686 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679990758 | Brittany Channing-noble Lister | Dermatology | 550 Munson Ave Ste 200, Traverse City, MI 49686-3580 | 2014-03-26 |
| 1871851105 | Anthony C Vanvreede | Dermatology | 1225 W Front St Ste C, Traverse City, MI 49684-2368 | 2012-04-24 |
| 1801185202 | Patrick John Tobin | Dermatology | 7777 Truesdale Ln, Traverse City, MI 49686-1667 | 2011-04-06 |
| 1437268661 | Maria C Carroll | Dermatology | 550 Munson Ave, Suite 200, Traverse City, MI 49686 | 2006-08-30 |
| 1922536986 | V Dermatology | Dermatology | 1225 W Front St Ste C, Traverse City, MI 49684-2368 | 2017-06-02 |
| 1952410094 | Northwestern Michigan Dermatology PC | Dermatology | 550 Munson Ave, Suite 200, Traverse City, MI 49686-3580 | 2006-08-30 |
| 1285743393 | Paula L Cahill | Dermatology | 550 Munson Ave, Suite 200, Traverse City, MI 49686 | 2006-08-30 |
| 1770565384 | Jeffrey John Kelly | Dermatology | 3643 W Front St, Suite A, Traverse City, MI 49684-7759 | 2005-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710595616 | Diamond Dermatology, Pllc. | Dermatology | 3206 N Main St, Royal Oak, MI 48073-3424 | 2020-07-16 |
| 1477179174 | Alicia Scopis | Dermatology | 50505 Schoenherr Rd Ste 325, Shelby Township, MI 48315-3142 | 2020-06-18 |
| 1003460874 | Derm Institute of West Michigan Plc | Dermatology | 6750 Kalamazoo Ave, Suites C & D, Grand Rapids, MI 49508 | 2019-07-30 |
| 1770080939 | Emily Rose Davis | Dermatology | 5333 Mcauley Dr Rm 2111, Ypsilanti, MI 48197-1097 | 2018-04-12 |
| 1245744242 | Maureen Cliffel Do Pllc | Dermatology | 26454 Woodward Ave Ste 200, Royal Oak, MI 48067-0969 | 2017-11-29 |
| 1306375365 | Lindsay Christina El Awadi | Dermatology | 50182 Schoenherr Rd, Shelby Twp, MI 48315-3136 | 2017-06-05 |
| 1396278099 | Sasank Konda | Dermatology | 3031 W. Grand Blvd., 8th Floor, Dept. of Dermatology, Detroit, MI 48202 | 2017-04-10 |
| 1790132439 | Saara Kanervikkoaho-crane | Dermatology | 1517 Granger Ave, Ann Arbor, MI 48104-4426 | 2016-05-23 |
| 1588019053 | Legacy Dermatology Group PC | Dermatology | 1392 S Cass Lake Rd, Waterford, MI 48328 | 2016-05-03 |
| 1679955041 | Luke D Killpack | Dermatology | 5333 Mcauley Dr Rm 5003, Ypsilanti, MI 48197-1020 | 2015-06-22 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49686 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.