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General NPI Number Information
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NPI Number | 1316906068
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Entity Type | Individual
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Provider Name | SUSAN ELIZABETH BOYLAN MD
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Gender | Female
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 09/07/2018
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Provider Practice Location Address
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Address Line | 2280 OPITZ BLVD SUITE 120
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City | WOODBRIDGE
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State | VA
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Zip | 22191
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Country | US
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Telephone | 703-670-3349
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Fax | 703-590-3199
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Provider Business Mailing Address
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Address Line | 9568 KINGS CHARTER DR STE 202
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City | ASHLAND
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State | VA
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Zip | 23005-7955
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Country | US
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Telephone | 804-266-8717
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Fax | 804-266-5677
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 0101040413
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License Number State | VA
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