Organization
NORTHSIDE PARK GASTROENTEROLOGY & ENDOSCOPY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SUE MD (PHYSICIAN/OWNER)
(252) 335-4619
Entity
Organization
Contact information
Practice address
102 NORTHSIDE PARK DR, ELIZABETH CITY, NC 27909
(252) 335-4619
(252) 335-5744
Mailing address
102 NORTHSIDE PARK DR, ELIZABETH CITY, NC 27909
(252) 335-4619
(252) 335-5744
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
151718
NC
207RG0100X
Gastroenterology Physician
Primary
9600169
NC
Other
Enumeration date
09/26/2011
Last updated
10/22/2011
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