Provider Demographics
NPI:1407878416
Name:SUH, HO SUN H (MD)
Entity Type:Individual
Prefix:
First Name:HO SUN
Middle Name:H
Last Name:SUH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ERIK
Other - Middle Name:
Other - Last Name:SUH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:50 116TH AVE SE STE 111
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6436
Mailing Address - Country:US
Mailing Address - Phone:425-467-1314
Mailing Address - Fax:425-458-3102
Practice Address - Street 1:50 116TH AVE SE STE 111
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6436
Practice Address - Country:US
Practice Address - Phone:425-467-1314
Practice Address - Fax:425-458-3102
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040676207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0205718OtherL & I WORKERS COMP
WA8322299Medicaid
WA6520SUOtherREGENCE BLUESHIELD RIDER
WA8940773OtherL & I CRIME VICTIMS
WA8940773OtherL & I CRIME VICTIMS
WA8940773OtherL & I CRIME VICTIMS
WA0205718OtherL & I WORKERS COMP