Individual
DR. HEIDI D. GORSUCH-RAFFERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15195 HEATHCOTE BLVD STE 338, HAYMARKET, VA 20169-6244
(571) 261-3270
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(540) 564-7086
(540) 564-6847
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101243118
VA
208600000X
Surgery Physician
Primary
0101243118
VA
208600000X
Surgery Physician
036155910
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518981661
—
VA
Enumeration date
07/26/2006
Last updated
04/02/2021
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