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NPI Code Detail

MEDICARE: SUSAN S COGGIN MD

MEDICARE: SUSAN S COGGIN MD
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
1207Q00000XFamily Medicine Physician0101228408VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2080171016OTHERMEDICARE RAILROAD PROVIDER NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3217842OTHERANTHEM

General Provider Information

NPI Number : 1750363511
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN S COGGIN MD
Provider Business Mailing Address
First Line : PO BOX 2489
Second Line :
City : FOREST
State : VA
Zip : 24551-6489
Country : US
Telephone Number : 434-382-1139
Fax Number : 434-525-5748
Provider Business Practice Location Address
First Line : 1088 LONDON LINKS DR
Second Line :
City : FOREST
State : VA
Zip : 24551-4662
Country : US
Telephone Number : 434-534-6868
Fax Number : 434-534-8808
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 02/18/2010

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