Provider Demographics
NPI:1790708667
Name:RING, SUSAN E (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:RING
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 1:1004 FIRST COLONIAL RD
Mailing Address - Street 2:102
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454
Mailing Address - Country:US
Mailing Address - Phone:757-233-1184
Mailing Address - Fax:757-321-6145
Practice Address - Street 1:1004 FIRST COLONIAL RD
Practice Address - Street 2:102
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3070
Practice Address - Country:US
Practice Address - Phone:757-233-1184
Practice Address - Fax:757-321-6145
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040461207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA12100OtherOPTIMA HEALTH PLANS
VA217298OtherBCBS
VA12100OtherOPTIMA HEALTH PLANS
VA217298OtherBCBS