Individual
SUSAN S COGGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1088 LONDON LINKS DR, FOREST, VA 24551-4662
(434) 534-6868
(434) 534-8808
Mailing address
PO BOX 2489, FOREST, VA 24551-6489
(434) 382-1139
(434) 525-5748
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101228408
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005613451
—
VA
01
—
080171016
MEDICARE RAILROAD PROVIDER NUMBER
—
01
—
217842
ANTHEM
—
Enumeration date
11/17/2005
Last updated
02/18/2010
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