Provider Demographics
NPI:1841453982
Name:SZULC, SUSAN V (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:V
Last Name:SZULC
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 1:828 HEALTHY WAY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7958
Mailing Address - Country:US
Mailing Address - Phone:757-305-1797
Mailing Address - Fax:757-309-4715
Practice Address - Street 1:828 HEALTHY WAY
Practice Address - Street 2:SUITE 220
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-7958
Practice Address - Country:US
Practice Address - Phone:757-305-1797
Practice Address - Fax:757-309-4715
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101248259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherAETNA
VAPAROtherMULTIPLAN
VA10070392OtherOPTIMA HEALTH
VA427047OtherANTHEM BC/BS
VA1841453982Medicaid
VAPAROtherUSA MANAGED CARE
VAPAROtherUNITED HEALTHCARE
VA-028OtherTRICARE
NC5916745Medicaid
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherCORVEL
VAPAROtherCIGNA
VAPAROtherFIRST HEALTH COMMERCIAL/COVENTRY HEALTH/SOUTHERN HEALTH
VAPAROtherVIRGINIA PREMIER HEALTH PLAN
VAP00976369Medicare PIN
VAPAROtherMULTIPLAN