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General NPI Number Information
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NPI Number | 1003874587
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Entity Type | Individual
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Provider Name | SUSAN MARIE LESSNER-BOESLER DO
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Gender | Female
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | 124 OAK HOLW
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-8918
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Country | US
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Telephone | 757-206-6595
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Fax |
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Provider Business Mailing Address
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Address Line | 124 OAK HOLW
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-8918
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Country | US
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Telephone | 757-206-6595
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0102202443
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License Number State | VA
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