Provider Demographics
NPI:1972590685
Name:OWENSBY, SUSAN BIGNALL (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:BIGNALL
Last Name:OWENSBY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:209 PARK ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-5205
Mailing Address - Country:US
Mailing Address - Phone:704-829-0025
Mailing Address - Fax:704-829-0031
Practice Address - Street 1:209 PARK ST
Practice Address - Street 2:SUITE 500
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-5205
Practice Address - Country:US
Practice Address - Phone:704-829-0025
Practice Address - Fax:704-829-0031
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2011-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9601426208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891157AMedicaid
SCN01426Medicaid
NC891157AMedicaid