Provider Demographics
NPI:1295773943
Name:HSU, SEAN (MD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 STATION ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6304
Mailing Address - Country:US
Mailing Address - Phone:910-577-4300
Mailing Address - Fax:910-577-6630
Practice Address - Street 1:215 STATION ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6304
Practice Address - Country:US
Practice Address - Phone:910-577-4300
Practice Address - Fax:910-577-6630
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9801301207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1175XOtherBCBS
NC891175XMedicaid
NCF73696Medicare UPIN
NC891175XMedicaid