Provider Demographics
NPI:1831195338
Name:NEWSOME, SUSAN L (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:L
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:L
Other - Last Name:NEARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3302 ALBERT LONG DR
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-2473
Mailing Address - Country:US
Mailing Address - Phone:540-434-0898
Mailing Address - Fax:540-433-9268
Practice Address - Street 1:3302 ALBERT LONG DR
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-2473
Practice Address - Country:US
Practice Address - Phone:540-434-0898
Practice Address - Fax:540-433-9268
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101045979208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
466031OtherANTHEM
VA006739601Medicaid
66814OtherOPTIMA
232357OtherSOUTHERN HEALTH
4522796005OtherCIGNA
F76028Medicare UPIN