Doctor Name: | ALAN WESLEY SUE |
NPI Number: | 1013235357 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | EL1790 |
Business Practice Address: | 2060 4th St Unit 140 Berkeley, CA - 947101955 |
Business Phone Number: | 5103322882 |
Business Fax Number: | 5103322882 |
Mailing Address: | 2060 4th St, Unit 140 BERKELEY |
State: | CA |
Postal Code: | 947101955 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/11/2010 |
NPI Last Update Date: | 04/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | EL1790 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |