Provider Demographics
NPI:1568546430
Name:SUGG, JOHN BRINKLEY (NP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BRINKLEY
Last Name:SUGG
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11635 CAPITAL BLVD STE 200
Mailing Address - Street 2:WAKE FOREST FAMILY PHYSICIANS
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9350
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11635 CAPITAL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-9350
Practice Address - Country:US
Practice Address - Phone:919-570-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200925207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2598521AMedicare PIN
NCP02951Medicare UPIN
NC2598521BMedicare PIN