Provider Demographics
NPI:1033103197
Name:HAND, SUZANNE M (MD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:HAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 MERRILEE DR
Mailing Address - Street 2:STE 230
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4400
Mailing Address - Country:US
Mailing Address - Phone:703-698-4444
Mailing Address - Fax:
Practice Address - Street 1:2722 MERRILEE DR
Practice Address - Street 2:STE 230
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4400
Practice Address - Country:US
Practice Address - Phone:703-698-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00901822085R0202X
IN01050849A2085R0202X
IN010508492085R0202X
VA01012707092085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200252300Medicaid
IN200346250Medicaid
IN980210IIMedicare PIN
IN184870Medicare ID - Type UnspecifiedGROUP #
IN200346250Medicaid
IN214160QMedicare PIN
IN542650NNMedicare PIN
INE76695Medicare UPIN
IN184870AMedicare ID - Type Unspecified
IN200252300Medicaid
ILK51350Medicare PIN