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Individual

MARK L SU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
255 LOW ST STE 202, NEWBURYPORT, MA 01950
(978) 225-0378
Mailing address
59 WASHINGTON ST, NEWBURYPORT, MA 01950-2306

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
216973
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2011450
MA
Enumeration date
06/14/2005
Last updated
10/11/2019
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