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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. SUSAN LICATA DURHAM, OD

Active

DR. SUSAN LICATA DURHAM, OD is a Pediatric Optometrist healthcare provider located in RALEIGH, North Carolina. NPI 1023043163 is currently active in the NPPES registry. Verify at CMS.

Pediatric Optometrist · RALEIGH, NC

Registration Details

NPI Number
1023043163
Provider Type
Individual
Gender
Female
NPI Issued
Jul 11, 2006 (20.10825984049 yrs)
Last Updated
Sep 29, 2011
Licenses
1335 (NC)
1335 (NC)
1335 (NC)
1335 (NC)
1335 (NC)

Practice Information

Address
10207 CERNY ST
SUITE 100
RALEIGH, NC, 276177878
Browse NC providers · Browse ZIP 27617
Phone
9193612299
Fax
9193610055
Primary Specialty
Pediatric Optometrist
152WP0200X
Additional Specialty
Pediatric Optometrist
Additional Specialty
Sports Vision Optometrist
Additional Specialty
Vision Therapy Optometrist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.