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NPI Code Detail

MEDICARE: SUSAN IRBY MD

MEDICARE: SUSAN IRBY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician0101245877VA

General Provider Information

NPI Number : 1144262528
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN IRBY MD
Provider Business Mailing Address
First Line : 13205 BOOKER T WASHINGTON HWY
Second Line :
City : HARDY
State : VA
Zip : 24101-3947
Country : US
Telephone Number : 540-721-2689
Fax Number : 540-721-3623
Provider Business Practice Location Address
First Line : 13205 BOOKER T WASHINGTON HWY
Second Line :
City : HARDY
State : VA
Zip : 24101-3947
Country : US
Telephone Number : 540-721-2689
Fax Number : 540-721-3623
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 08/12/2011

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