Provider Demographics
NPI:1285922260
Name:GIROIS, SUSAN B (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:B
Last Name:GIROIS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:E
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:4014 CONNECTION POINT BLVD. SUITE C
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212
Mailing Address - Country:US
Mailing Address - Phone:704-343-8282
Mailing Address - Fax:
Practice Address - Street 1:3960 TURNPIKE ROAD
Practice Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL CENTER VICTORY, LLC
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701
Practice Address - Country:US
Practice Address - Phone:757-393-1136
Practice Address - Fax:757-282-7600
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS5904207R00000X
NC2019-02878207R00000X
VA0101249567207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5918233Medicaid
VA-002OtherTRICARE/CHAMPUS
VA1285922260OtherUNITED HEALTHCARE/MAMSI
VAPAROtherUSA MANAGED CARE
VAPAROtherCORVEL
VA1285922260Medicaid
VAPAROtherMULTIPLAN
VAC01883Medicare UPIN
NC5918233Medicaid
VAPAROtherCORVEL
VA1306800198Medicare PIN