Provider Demographics
NPI:1093781411
Name:SUGG, NORMAN KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:KEITH
Last Name:SUGG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 30369
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27130-0369
Mailing Address - Country:US
Mailing Address - Phone:336-718-5856
Mailing Address - Fax:336-718-9259
Practice Address - Street 1:3333 SILAS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3013
Practice Address - Country:US
Practice Address - Phone:336-718-5856
Practice Address - Fax:336-718-9259
Is Sole Proprietor?:No
Enumeration Date:2006-02-25
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26876207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7980757Medicaid
NC80857OtherBCBS
NC220020988Medicare PIN
NC213472BMedicare PIN
NC80857OtherBCBS
NC7980757Medicaid
NC213472CMedicare PIN