Basic Information
| Provider Information | |||||||||
| NPI: | 1427462142 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | ELENA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8502 WAGON WHEEL RD | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 223092147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148090000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9300 DEWITT LOOP | ||||||||
| Address2: | FORT BELVOIR COMMUNITY HOSPITAL | ||||||||
| City: | FORT BELVOIR | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5712311994 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2014 | ||||||||
| LastUpdateDate: | 06/20/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0116027288 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.