Provider Demographics
NPI:1811396179
Name:SUE, DONNA (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:SUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203-3825 SUNSET ST
Mailing Address - Street 2:
Mailing Address - City:BURNABY
Mailing Address - State:BC
Mailing Address - Zip Code:V5G 1T4
Mailing Address - Country:CA
Mailing Address - Phone:604-434-9515
Mailing Address - Fax:
Practice Address - Street 1:203-3825 SUNSET ST
Practice Address - Street 2:
Practice Address - City:BURNABY
Practice Address - State:BC
Practice Address - Zip Code:V5G 1T4
Practice Address - Country:CA
Practice Address - Phone:604-434-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA33332207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine