Basic Information
| Provider Information | |||||||||
| NPI: | 1073594164 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STIEGLER | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | TOMLINSON | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | TOMLINSON | ||||||||
| OtherFirstName: | SUSAN | ||||||||
| OtherMiddleName: | SHERRILL | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PA | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | FORT BELVOIR COMMUNITY HOSPITAL | ||||||||
| Address2: | 9300 DEWITT LOOP | ||||||||
| City: | FORT BELVOIR | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220605901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5712310720 | ||||||||
| FaxNumber: | 5712316607 | ||||||||
| Practice Location | |||||||||
| Address1: | 2480 LLEWELLYN AVE | ||||||||
| Address2: | FT. GEORGE G. MEADE | ||||||||
| City: | FT MEADE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207555800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016778800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2005 | ||||||||
| LastUpdateDate: | 05/26/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 05/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | C0001556 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.