Provider Demographics
NPI:1295765436
Name:NOH, SUNGRAN S (MD)
Entity type:Individual
Prefix:
First Name:SUNGRAN
Middle Name:S
Last Name:NOH
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 1:850 CLAIRTON BLVD STE 1100
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4567
Mailing Address - Country:US
Mailing Address - Phone:412-385-7138
Mailing Address - Fax:949-553-3545
Practice Address - Street 1:850 CLAIRTON BLVD STE 1100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-4567
Practice Address - Country:US
Practice Address - Phone:412-385-7138
Practice Address - Fax:949-553-3545
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051944L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014783500004Medicaid
PA0014783500004Medicaid
PA195202KH3Medicare ID - Type Unspecified