Individual
DR. SUZANNE M EVERHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.,P.C.
Contact information
Practice address
204 VIRGINIA ST, ASHLAND, VA 23005-2049
(804) 752-7508
(804) 798-6876
Mailing address
204 VIRGINIA ST, ASHLAND, VA 23005-2049
(804) 752-7508
(804) 798-6876
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0102037079
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006301495
—
VA
01
—
047741
BLUE CROSS BLUE SHILED VA
VA
01
—
412574
ALLIANCE,OPTIMUM,MDIPA
VA
01
—
433600120
PRIVATE HEALTHCARE SYSTEM
VA
01
—
45783
OPTIMA HEALTH
VA
01
—
668240
AETNA PROVIDER NUMBER
VA
Enumeration date
08/29/2006
Last updated
11/02/2011
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