Provider Demographics
NPI:1275810103
Name:LOPRESTI, SUSAN LUM (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LUM
Last Name:LOPRESTI
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 1:57 DAYS NECK RD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-2647
Mailing Address - Country:US
Mailing Address - Phone:757-357-0784
Mailing Address - Fax:757-357-0784
Practice Address - Street 1:15 W MERCURY BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-2508
Practice Address - Country:US
Practice Address - Phone:757-726-0501
Practice Address - Fax:757-726-0394
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-06
Last Update Date:2011-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034674207ZB0001X, 207ZC0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine