Individual
SUSAN L CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 NASH MEDICAL ARTS MALL, ROCKY MOUNT, NC 27804-1400
(252) 451-3100
(252) 451-3141
Mailing address
100 NASH MEDICAL ARTS MALL, ROCKY MOUNT, NC 27804-1400
(252) 451-3100
(252) 451-3141
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28956
NC
2080N0001X
Neonatal-Perinatal Medicine Physician
28956
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1521919
CIGNA HEALTHCARE
NC
01
—
22480
BCBSNC
NC
01
—
69963
MEDCOST
NC
05
—
7922480
—
NC
Enumeration date
09/08/2005
Last updated
08/22/2007
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