Basic Information
Provider Information
NPI: 1386267219
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SUH
FirstName: YU MIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5210 ENVIRON WAY
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275174467
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 130 MASON FARM ROAD
Address2: 3159C BIOINFORMATICS BUILDING
City: CHAPEL HILL
State: NC
PostalCode: 25799
CountryCode: US
TelephoneNumber: 9199669071
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/27/2020
LastUpdateDate: 05/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X262445NCY Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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