Provider Demographics
NPI:1942722053
Name:SUK, EUNDAE (DC)
Entity Type:Individual
Prefix:
First Name:EUNDAE
Middle Name:
Last Name:SUK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 YORK RD STE 302
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6054
Mailing Address - Country:US
Mailing Address - Phone:410-583-5654
Mailing Address - Fax:
Practice Address - Street 1:1741 DORSEY RD STE 104
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1188
Practice Address - Country:US
Practice Address - Phone:410-774-9870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03812111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor