MEDICARE: WINNIE SUEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	216970	MA
2	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	216970	MA
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	15919	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134181019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WINNIE SUEN MD

Provider Business Mailing Address
First Line	:	1575 S BERETANIA ST STE 205
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96826-1141
Country	:	US
Telephone Number	:	808-202-2515
Fax Number	:	808-204-1620

Provider Business Practice Location Address
First Line	:	1783 PIIKEA ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96818-1849
Country	:	US
Telephone Number	:	808-543-1188
Fax Number	:	808-543-1189

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	01/31/2025

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Directions to “ WINNIE SUEN MD” Practice Location

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