Provider Demographics
NPI:1215047246
Name:SUBURBAN WOMEN'S SPECIALISTS, LLC
Entity type:Organization
Organization Name:SUBURBAN WOMEN'S SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUIZA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHUA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-476-1088
Mailing Address - Street 1:PO BOX 598
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-0598
Mailing Address - Country:US
Mailing Address - Phone:770-476-1088
Mailing Address - Fax:678-206-0346
Practice Address - Street 1:6300 HOSPITAL PKWY STE 200
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1984
Practice Address - Country:US
Practice Address - Phone:770-476-1088
Practice Address - Fax:770-476-1082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty