Laurie, Susan M

Laurie, Susan M is an individual health care provider with primary practice located at 2955 Ivy Road Suite 205, Charlottesville VA 22908-1205. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Laurie, Susan M can be contacted via phone (434) 243-4500.

Contact Information

Primary practice address
2955 Ivy Road Suite 205 Charlottesville VA 22908-1205
Phone: (434) 243-4500
Fax: (434) 293-8570
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 0101050075 Virginia

Profile Details

NPI number 1932182524
LBN Legal business name Laurie, Susan M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2005
Last updated Dec 6th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932182524 NPPES
Virginia Other 5012655 AETNA
Virginia Other 142664 AETNA
Virginia Other 110223792 AETNA
Virginia Other 011594 AETNA
Virginia Other 141036 AETNA
Virginia MEDICAID 5805104 AETNA
Virginia Other 893815 AETNA
Virginia MEDICAID 005805104 AETNA

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