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General NPI Number Information
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NPI Number | 1215047246
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Entity Type | Organization
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Legal Business Name | SUBURBAN WOMEN'S SPECIALISTS, LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 6300 HOSPITAL PKWY STE 200
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City | JOHNS CREEK
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State | GA
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Zip | 30097-1984
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Country | US
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Telephone | 770-476-1088
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Fax | 770-476-1082
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Provider Business Mailing Address
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Address Line | PO BOX 598
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City | SUWANEE
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State | GA
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Zip | 30024-0598
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Country | US
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Telephone | 770-476-1088
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Fax | 678-206-0346
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Authorized Official
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Title or Position | PHYSICIAN
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Name | SUIZA C. CHUA
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Credential | M.D.
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Telephone | 770-476-1088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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