Provider Demographics
NPI:1447506183
Name:SUH, NINA
Entity type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:SUH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 S COBB DR SE STE 275
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6455
Mailing Address - Country:US
Mailing Address - Phone:404-251-2119
Mailing Address - Fax:404-251-2104
Practice Address - Street 1:3903 S COBB DR SE STE 275
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6455
Practice Address - Country:US
Practice Address - Phone:404-251-2119
Practice Address - Fax:404-251-2104
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN107046207XS0106X
MN57107207XS0106X
NYP83267207XS0106X
GA287888207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH400096480Medicare PIN