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Individual

YOUNG SOO SUH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1606 N 7TH ST, TERRE HAUTE, IN 47804-2706
(812) 238-7000
Mailing address
PO BOX 2505, INDIANAPOLIS, IN 46206-2505
(812) 238-7783
(812) 238-4506

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01027594A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100330210
IN
01
300123927
RR MEDICARE
IN
Enumeration date
11/03/2005
Last updated
10/18/2010
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