Individual
DR. SUHAIL BAHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2727
Mailing address
PO BOX 3002, LONGVIEW, WA 98632-0302
(360) 414-2048
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-094040
OH
207R00000X
Internal Medicine Physician
MD60134149
WA
208M00000X
Hospitalist Physician
Primary
MD60134149
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0260225
LABOR & INDUSTRIES
WA
05
—
500619069
—
OR
05
—
8566192
—
WA
01
—
P00823196
RAILROAD MEDICARE
WA
Enumeration date
03/17/2008
Last updated
11/22/2010
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