Provider Demographics
NPI:1942380621
Name:LI, DAVID SUI NG (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SUI NG
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SUI NG
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:130 MALLARD ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4046
Mailing Address - Country:US
Mailing Address - Phone:864-233-1534
Mailing Address - Fax:864-233-3403
Practice Address - Street 1:130 MALLARD ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-4046
Practice Address - Country:US
Practice Address - Phone:864-233-1534
Practice Address - Fax:864-233-3403
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15607207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCF54979Medicare UPIN