Provider Demographics
NPI:1588935829
Name:SLUSSER, HEATHER STERLING (MD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:STERLING
Last Name:SLUSSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:STERLING
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:672 VANDALIA DRIVE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519
Mailing Address - Country:US
Mailing Address - Phone:916-847-5949
Mailing Address - Fax:
Practice Address - Street 1:1750 TOMCAT BLVD
Practice Address - Street 2:BRANCH MEDICAL CLINIC OCEANA
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23460-2168
Practice Address - Country:US
Practice Address - Phone:916-847-5949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2013-01450208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FC4302612OtherDEA