Healthcare Provider Details

I. General information

NPI: 1730241746
Provider Name (Legal Business Name): SUE-ANNE TOH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE ST 1 MALONEY
PHILADELPHIA PA
19104-4206
US

IV. Provider business mailing address

3400 SPRUCE ST 1 MALONEY
PHILADELPHIA PA
19104-4206
US

V. Phone/Fax

Practice location:
  • Phone: 215-746-6391
  • Fax:
Mailing address:
  • Phone: 215-746-6391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMT183438
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: