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Individual

RANDALL H SUSLICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
946 N MAIN ST, CHASE CITY, VA 23924-1139
(434) 372-5141
(434) 372-8910
Mailing address
946 N MAIN ST, CHASE CITY, VA 23924-1139
(434) 372-5141
(434) 372-8910

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101032102
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007610114
VA
Enumeration date
06/10/2005
Last updated
06/23/2009
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