Healthcare Provider Details

I. General information

NPI: 1730348509
Provider Name (Legal Business Name): SUNA SEO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUNA CHOI

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW 3112 MAIN BUILDING
WASHINGTON DC
20007
US

IV. Provider business mailing address

3800 RESERVOIR RD NW 3112 MAIN BUILDING
WASHINGTON DC
20007
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8569
  • Fax: 202-444-4747
Mailing address:
  • Phone: 202-444-8569
  • Fax: 202-444-4747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD038797
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0077988
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: