Healthcare Provider Details

I. General information

NPI: 1316359458
Provider Name (Legal Business Name): SUSAN E ATKINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2014
Last Update Date: 05/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 HIOAKS RD
RICHMOND VA
23225-4040
US

IV. Provider business mailing address

1011 HIOAKS RD
RICHMOND VA
23225-4040
US

V. Phone/Fax

Practice location:
  • Phone: 804-272-2580
  • Fax: 804-272-2586
Mailing address:
  • Phone: 804-272-0726
  • Fax: 804-272-2586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number0101047136
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: