Provider Demographics
NPI:1952159824
Name:NDE, GEORGE SUH
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:SUH
Last Name:NDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2381 TERRAPIN XING
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:MD
Mailing Address - Zip Code:20794-9830
Mailing Address - Country:US
Mailing Address - Phone:240-486-8512
Mailing Address - Fax:
Practice Address - Street 1:2381 TERRAPIN XING
Practice Address - Street 2:
Practice Address - City:JESSUP
Practice Address - State:MD
Practice Address - Zip Code:20794-9830
Practice Address - Country:US
Practice Address - Phone:240-486-8512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator