Individual
SUSAN FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2215 LANDOVER PL, LYNCHBURG, VA 24501-2115
(434) 947-3944
(434) 544-2316
Mailing address
PO BOX 11889, LYNCHBURG, VA 24506-1889
(434) 947-3944
(434) 544-2316
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101045558
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00173401
MEDICARE RAILROAD CARRIER
VA
Enumeration date
11/29/2005
Last updated
11/28/2007
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