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General NPI Number Information
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NPI Number | 1346109105
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Entity Type | Individual
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Provider Name | MICHELLE SU
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Gender | Female
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 4944 WYACONDA RD
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City | ROCKVILLE
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State | MD
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Zip | 20852-2444
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Country | US
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Telephone | 301-880-6064
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Fax |
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Provider Business Mailing Address
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Address Line | 14302 STONEVIEW PL
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-4361
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Country | US
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Telephone |
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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