Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 6869 | NE |
N | 208600000X | Surgeon | 6869 | NE |
Y | 2086S0120X | Pediatric Surgery | 31778 | NE |
NPI | 1316201742 |
---|---|
Provider Name | Melissa Suh |
First Address | Boys Town, NE 68010 |
Second Address | Boys Town, NE 68010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2012 |
Last Update Date | 01/09/2021 |