Provider Demographics
NPI:1619033164
Name:TEOH, SU WOOI (MD)
Entity Type:Individual
Prefix:DR
First Name:SU WOOI
Middle Name:
Last Name:TEOH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6318 POPLAR FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27358-9339
Mailing Address - Country:US
Mailing Address - Phone:336-392-0350
Mailing Address - Fax:336-542-2017
Practice Address - Street 1:3824 N ELM ST STE 201
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2733
Practice Address - Country:US
Practice Address - Phone:336-542-2015
Practice Address - Fax:336-542-2017
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200601952207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905933Medicaid