Individual
DR. SUSAN K BUENAVENTURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5425 DUKE STREET, ALEXANDRIA, VA 22304
(703) 751-0800
(703) 751-4378
Mailing address
5425 DUKE STREET, ALEXANDRIA, VA 22304
(703) 751-0800
(703) 751-4378
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
0101051213
VA
2086S0122X
Plastic and Reconstructive Surgery Physician
9400735
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184854
ANTHEM
VA
01
—
4819
BC BS NCA
—
Enumeration date
02/03/2006
Last updated
07/08/2007
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