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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. SU MIN KO, M.D.

Active

DR. SU MIN KO, M.D. is a Interventional Vascular Surgery healthcare provider located in FAIRFAX, Virginia. NPI 1336375450 is currently active in the NPPES registry. Verify at CMS.

Interventional Vascular Surgery · FAIRFAX, VA

Registration Details

NPI Number
1336375450
Provider Type
Individual
Gender
Male
NPI Issued
Jun 3, 2009 (17.176685395183 yrs)
Last Updated
Feb 20, 2017
Licenses
0101250991 (VA)
2009001606 (MO)
2009001606 (MO)
0101250991 (VA)

Practice Information

Address
11166 FAIRFAX BLVD
SUITE 105
FAIRFAX, VA, 220305017
Browse VA providers · Browse ZIP 22030
Phone
7032773360
Fax
7032773370
Primary Specialty
Interventional Vascular Surgery
208VP0014X
Additional Specialty
Pain Medicine (PM&R)
Additional Specialty
Pain Medicine (PM&R)

Other Interventional Vascular Surgery Providers in FAIRFAX, VA

Name Credential NPI
DR. RODNEY B DADE MD 1336117373
DR. ROBERT HARRISON WAGNER MD 1457329997
DR. MARINA PROTOPAPAS D.O. 1760448666
BEVERLY A WHITTENBERG MD 1366483034
DAVID KIM MD 1073530523
AMGAD W ABDOU M.D. 1447384011
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.