Healthcare Provider Details

I. General information

NPI: 1639140569
Provider Name (Legal Business Name): SUSAN LEWIS PILLSBURY DAVID M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 12/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 POCOSHOCK PL SUITE 302
RICHMOND VA
23235-6345
US

IV. Provider business mailing address

2500 POCOSHOCK PL SUITE 302
RICHMOND VA
23235-6345
US

V. Phone/Fax

Practice location:
  • Phone: 804-674-1985
  • Fax: 804-276-1048
Mailing address:
  • Phone: 804-674-1985
  • Fax: 804-276-1048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101032090
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: