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Individual
DR. SUSAN AUCOTT BALLAGH
Active
Individual
DR. SUSAN AUCOTT BALLAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101056727
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
G62297
CA
207VE0102X
Reproductive Endocrinology Physician
0101056727
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006210724
—
VA
01
—
0612M
NC BC/BS
NC
01
—
332690
ANTHEM
VA
01
—
351316
UHC/MAMSI
—
01
—
56588
SENTARA
VA
05
—
790612M
—
NC
Enumeration date
01/30/2006
Last updated
08/11/2010
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