| Suh & Suh Md Inc | |
|
725 Kapiolani Blvd Ste C114 Honolulu HI 96813-6016 | |
| (808) 946-1414 | |
| (808) 946-1515 |
| Full Name | Suh & Suh Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 725 Kapiolani Blvd Ste C114, Honolulu, Hawaii |
| Authorized Official Name and Position | Philip Jung Suh (OWNER) |
| Authorized Official Contact | 8089461414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suh & Suh Md Inc 725 Kapiolani Blvd Ste C114 Honolulu HI 96813-6016 Ph: (808) 946-1414 | Suh & Suh Md Inc 725 Kapiolani Blvd Ste C114 Honolulu HI 96813-6016 Ph: (808) 946-1414 |
| NPI Number | 1124124243 |
|---|---|
| Provider Enumeration Date | 09/16/2006 |
| Last Update Date | 10/25/2017 |
| Medicare PECOS PAC ID | 1557250727 |
|---|---|
| Medicare Enrollment ID | O20040315000509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124124243 | NPI | - | NPPES |
| 50149601 | Medicaid | HI | |
| 03532001 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 10040 (Hawaii) | Primary |
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 2519 (Hawaii) | Secondary |
| Provider Name | Philip J Suh |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1518934009 PECOS PAC ID: 6406745686 Enrollment ID: I20110818000159 |
| Provider Name | Kanna Dokgo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760843890 PECOS PAC ID: 2961769930 Enrollment ID: I20171129001380 |
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