Individual
MRS. SUZANNE WHITNEY COURTNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
527 MEDICAL PARK DR STE 500, BRIDGEPORT, WV 26330-9010
(681) 342-3600
(681) 342-3625
Mailing address
527 MEDICAL PARK DR STE 500, BRIDGEPORT, WV 26330-9010
(681) 342-3600
(681) 342-3625
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2052
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001886752
BLUE CROSS BLUE SHIELD
WV
05
—
3810005855
—
WV
01
—
550525724
TAX IDENTIFICATION
WV
01
—
P00363062
RAILROAD MEDICARE
WV
01
—
WV2052
HEALTH PLAN OF UPPER OHIO
WV
Enumeration date
06/24/2006
Last updated
04/06/2022
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