Provider Demographics
NPI:1326171513
Name:BEATTY, SUSAN EDWARDS (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:EDWARDS
Last Name:BEATTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:842 PARK WAY AVE
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-5323
Mailing Address - Country:US
Mailing Address - Phone:540-721-1290
Mailing Address - Fax:540-721-1290
Practice Address - Street 1:842 PARK WAY AVE
Practice Address - Street 2:
Practice Address - City:MONETA
Practice Address - State:VA
Practice Address - Zip Code:24121-5323
Practice Address - Country:US
Practice Address - Phone:540-721-1290
Practice Address - Fax:540-721-1290
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101235628207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease