Active NPI
Alan Su, M.D.
- Psychiatry Physician
- Charleston, SC
National Provider Identifier
1730443573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- LL34852
- Practice address
- 109 Bee St
Charleston, SC 29401-5703 - Phone
- (843) 792-5011
- NPI assigned
- Jun 26, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | LL34852 | SC | Primary |
Addresses
Primary practice location
109 Bee St
Charleston, SC 29401-5703
Mailing address
109 Bee St
Charleston, SC 29401-5703
Phone (843) 792-5011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL34852 | SC | MD | Psychiatry Physician |
| 34852 | SC | MD | Vascular Sonography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470787200000",
"number": "1730443573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 BEE ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294015703",
"telephone_number": "843-792-5011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 BEE ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294015703",
"telephone_number": "843-792-5011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SU",
"first_name": "ALAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-26",
"last_updated": "2016-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "SC",
"license": "LL34852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.