Provider Demographics
NPI:1700097060
Name:RINGEMAN, SUSANNA S (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSANNA
Middle Name:S
Last Name:RINGEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUSANNA
Other - Middle Name:M
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2827 LYNDHURST AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-4145
Mailing Address - Country:US
Mailing Address - Phone:336-842-5477
Mailing Address - Fax:336-602-2591
Practice Address - Street 1:2827 LYNDHURST AVE STE 204
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-4145
Practice Address - Country:US
Practice Address - Phone:336-842-5477
Practice Address - Fax:336-602-2591
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201201124207W00000X, 207W00000X
LA202175207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5921398Medicaid