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Individual

ANDREW T SU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 268-6511
(937) 267-5316
Mailing address
4100 WEST THIRD STREET, DAYTON, OH 45428
(937) 268-6511
(937) 267-5316

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35062288
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0923915
OH
Enumeration date
06/09/2005
Last updated
09/18/2017
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