Individual
ISAAC E SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7600 CENTRAL AVE, PHILADELPHIA, PA 19111-2442
(215) 728-2275
Mailing address
3500 N BROAD ST RM 1A, PHILADELPHIA, PA 19140-4106
(215) 926-9019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11686
GA
207Q00000X
Family Medicine Physician
Primary
MD484167
PA
208D00000X
General Practice Physician
92495
CA
Other
Enumeration date
06/23/2020
Last updated
06/27/2024
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