Provider Demographics
NPI:1831128917
Name:JAMES J SUH MD PC
Entity Type:Organization
Organization Name:JAMES J SUH MD PC
Other - Org Name:INTERNAL MEDICINE CENTER OF VIRGINIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-916-0005
Mailing Address - Street 1:2826 OLD LEE HWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4348
Mailing Address - Country:US
Mailing Address - Phone:703-916-0005
Mailing Address - Fax:703-916-1275
Practice Address - Street 1:2826 OLD LEE HWY
Practice Address - Street 2:SUITE 250
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4348
Practice Address - Country:US
Practice Address - Phone:703-916-0005
Practice Address - Fax:703-916-1275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101045666207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G02374Medicare PIN
F43062Medicare UPIN