Individual
LILY SUH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-3933
(501) 364-1874
Mailing address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-3933
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
87503
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2019
Last updated
04/30/2022
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