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NPI Code Detail

MEDICARE: SUZANNA IVEZIC PHARMD

MEDICARE: SUZANNA IVEZIC PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist5302038836MI

General Provider Information

NPI Number : 1295174605
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNA IVEZIC PHARMD
Provider Business Mailing Address
First Line : 2887 S ROCHESTER RD
Second Line : T-0351
City : ROCHESTER HILLS
State : MI
Zip : 48307-4580
Country : US
Telephone Number : 248-844-5471
Fax Number :
Provider Business Practice Location Address
First Line : 2887 S ROCHESTER RD
Second Line : T-0351
City : ROCHESTER HILLS
State : MI
Zip : 48307-4580
Country : US
Telephone Number : 248-844-5471
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2013
Last Update Date : 06/19/2013

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Directions to “ SUZANNA IVEZIC PHARMD” Practice Location

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