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General NPI Number Information
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NPI Number | 1316201742
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Entity Type | Individual
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Provider Name | MELISSA SUH M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/29/2012
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 14080 HOSPITAL ROAD
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City | BOYS TOWN
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State | NE
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Zip | 68010
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Country | US
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Telephone | 531-355-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 14080 HOSPITAL ROAD
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City | BOYS TOWN
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State | NE
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Zip | 68010
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Country | US
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Telephone | 531-355-7400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 6869
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | 31778
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License Number State | NE
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