Provider Demographics
NPI:1487971305
Name:SUEN, SUNLUNG (MD)
Entity type:Individual
Prefix:DR
First Name:SUNLUNG
Middle Name:
Last Name:SUEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 COLDWATER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-8028
Mailing Address - Country:US
Mailing Address - Phone:262-521-8800
Mailing Address - Fax:
Practice Address - Street 1:1625 COLDWATER CREEK DR
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-8028
Practice Address - Country:US
Practice Address - Phone:262-521-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI57312208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400235701Medicare PIN