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NPI Code Detail

MEDICARE: SUSANNA A MATHE M.D.

MEDICARE: SUSANNA A MATHE M.D.
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
12084N0400XNeurology Physician0101038574VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508837238
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSANNA A MATHE M.D.
Provider Business Mailing Address
First Line : 7301 FOREST AVE
Second Line : SUITE 302
City : RICHMOND
State : VA
Zip : 23226-3792
Country : US
Telephone Number : 804-288-2767
Fax Number : 804-288-9897
Provider Business Practice Location Address
First Line : 165 WADSWORTH DR
Second Line :
City : RICHMOND
State : VA
Zip : 23236-4500
Country : US
Telephone Number : 804-272-9146
Fax Number : 804-330-5929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 04/23/2013

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Directions to “ SUSANNA A MATHE M.D.” Practice Location

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