Provider Demographics
NPI:1134181019
Name:SUEN, WINNIE (MD)
Entity type:Individual
Prefix:
First Name:WINNIE
Middle Name:
Last Name:SUEN
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 1:1575 S BERETANIA ST STE 205
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1141
Mailing Address - Country:US
Mailing Address - Phone:808-202-2515
Mailing Address - Fax:808-204-1620
Practice Address - Street 1:1783 PIIKEA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-1849
Practice Address - Country:US
Practice Address - Phone:808-543-1188
Practice Address - Fax:808-543-1189
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216970207RG0300X, 207RH0002X
HI15919207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110073332AMedicaid
MAI28423Medicare UPIN
MAA3831702Medicare PIN