Most Relevant Information
Provider Data
| NPI Number: | 1003540451 |
| Provider Name: | ROGER SU MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/12/2022 |
| Last Updated: | 03/21/2024 |
Provider Practice Location
833 CAMPBELL HILL ST. NW
SUITE 250
MARIETTA
GA
300601162
Practice Location Phone/Fax
| Phone: | 4709562020 |
| Fax: | 7709992785 |
Provider Mailing Location
677 CHURCH ST.
GREEN TOWER, LOWER LEVEL
MARIETTA
GA
300601101
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |