Provider Demographics
NPI:1730170952
Name:YEH, SUNU SUSAN (MD)
Entity type:Individual
Prefix:DR
First Name:SUNU
Middle Name:SUSAN
Last Name:YEH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIANORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:781-487-4040
Mailing Address - Fax:781-487-2870
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAW 4740E
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-6700
Practice Address - Fax:617-724-6725
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2012-07-23
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Provider Licenses
StateLicense IDTaxonomies
MA217737207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2017920Medicaid
MAJ26637OtherBCBS MA
MA468528OtherTUFTS HEALTH PLAN
MA468528OtherTUFTS HEALTH PLAN
MAA36010Medicare ID - Type Unspecified