Provider Demographics
NPI:1700816337
Name:MUELLER, SUSAN N (OD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:N
Last Name:MUELLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:866-795-4020
Practice Address - Street 1:441 WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1643
Practice Address - Country:US
Practice Address - Phone:434-973-5361
Practice Address - Fax:434-973-6925
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000097152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA077216OtherANTHEM
VA077216OtherANTHEM
VAV22078Medicare UPIN