Individual
DR. SUSAN M LAURIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2955 IVY ROAD, SUITE 205, CHARLOTTESVILLE, VA 22908-1205
(434) 243-4500
(434) 293-8570
Mailing address
2955 IVY ROAD, SUITE 205, CHARLOTTESVILLE, VA 22908-1205
(434) 243-4500
(434) 293-8570
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101050075
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005805104
—
VA
01
—
011594
CIGNA
VA
01
—
110223792
MEDICARE RAILROAD
VA
01
—
141036
ANTHEM
VA
01
—
142664
SOUTHERN HEALTH
VA
01
—
5012655
AETNA
VA
05
—
5805104
—
VA
01
—
893815
MAMSI
VA
Enumeration date
11/28/2005
Last updated
12/06/2010
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