Individual
DR. SUSAN KATHLEEN FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8100 ASHTON AVE, STE. 207, MANASSAS, VA 20109-5622
(703) 334-5801
(703) 334-5805
Mailing address
8100 ASHTON AVE, STE. 207, MANASSAS, VA 20109-5622
(703) 334-5801
(703) 334-5805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101057533
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2199062
AETNA HMO
—
01
—
309288
ANTHEM BC/BS
VA
01
—
5649863
CIGNA PPO/HMO
VA
01
—
7049008
AETNA
—
Enumeration date
09/21/2005
Last updated
01/06/2011
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