Provider Demographics
NPI:1568423119
Name:LINCOLN, SUSAN VG (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:VG
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:392 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2411
Mailing Address - Country:US
Mailing Address - Phone:617-754-1800
Mailing Address - Fax:617-754-1820
Practice Address - Street 1:392 CHESTNUT ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2411
Practice Address - Country:US
Practice Address - Phone:617-754-1800
Practice Address - Fax:617-754-1820
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2015-04-15
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Provider Licenses
StateLicense IDTaxonomies
MA50236207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA712272OtherTUFTS
MA0700747OtherUNITED HEALTH CARE
MA13152OtherHARVARD PILGRIM
MAA57238Medicare UPIN
MAJ04286OtherBLUE CROSS BLUE SHIELD
MAJ04286Medicare ID - Type Unspecified