Provider Demographics
NPI:1770370595
Name:SUEN-WALLACH, ALISA ANPING (MD, PHD)
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:ANPING
Last Name:SUEN-WALLACH
Suffix:
Gender:
Credentials:MD, PHD
Other - Prefix:
Other - First Name:ALISA
Other - Middle Name:ANPING
Other - Last Name:SUEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 EASTOWNE DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2286
Mailing Address - Country:US
Mailing Address - Phone:984-974-4462
Mailing Address - Fax:919-843-9355
Practice Address - Street 1:100 EASTOWNE DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2286
Practice Address - Country:US
Practice Address - Phone:984-974-4462
Practice Address - Fax:919-843-9355
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program