Provider Demographics
NPI:1306946249
Name:WORBOIS, SUZETTE C (DO)
Entity type:Individual
Prefix:DR
First Name:SUZETTE
Middle Name:C
Last Name:WORBOIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SUE
Other - Middle Name:FAIR
Other - Last Name:PARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-1239
Mailing Address - Country:US
Mailing Address - Phone:248-824-6600
Mailing Address - Fax:877-473-8164
Practice Address - Street 1:263 MCLAWS CIR
Practice Address - Street 2:SUITE# 105
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5674
Practice Address - Country:US
Practice Address - Phone:757-941-5600
Practice Address - Fax:757-564-0557
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA39020000X2084P0800X
VA0102202136208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV5641A - C03895Medicare PIN