Organization
K SUH MD PC
Active
Organization
K SUH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH SUH M.D. (PRESIDENT)
(716) 634-4798
Entity
Organization
Contact information
Practice address
338 HARRIS HILL RD, SUITE 207, WILLIAMSVILLE, NY 14221-7407
(716) 634-4798
(716) 634-0987
Mailing address
338 HARRIS HILL RD, SUITE 207, WILLIAMSVILLE, NY 14221-7407
(716) 634-4798
(716) 634-0987
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
112773-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000504465002
BLUE CROSS
NY
05
—
00587444
—
NY
01
—
2708505
INDEPENDENT HEALTH
NY
Enumeration date
09/26/2006
Last updated
08/06/2007
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