Provider Demographics
NPI:1689658759
Name:PENG, SUZETTE WEI-ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZETTE
Middle Name:WEI-ANN
Last Name:PENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11912 LEDGEROCK CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2155
Mailing Address - Country:US
Mailing Address - Phone:202-236-4664
Mailing Address - Fax:
Practice Address - Street 1:9300 DEWITT LOOP FL 1
Practice Address - Street 2:
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5285
Practice Address - Country:US
Practice Address - Phone:571-231-1402
Practice Address - Fax:571-231-6641
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101236549207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine