Provider Demographics
NPI:1851586366
Name:SU, SHO-CHI (OD)
Entity Type:Individual
Prefix:DR
First Name:SHO-CHI
Middle Name:
Last Name:SU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5552 MOUNTJOY CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-2442
Mailing Address - Country:US
Mailing Address - Phone:614-226-3989
Mailing Address - Fax:
Practice Address - Street 1:2727 FAIRFIELD COMMONS BLVD
Practice Address - Street 2:SPACE W179
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3778
Practice Address - Country:US
Practice Address - Phone:614-226-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5343152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist