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NPI Code Detail

MEDICARE: SUZANNE ALICE ALBRECHT MD

MEDICARE: SUZANNE ALICE ALBRECHT MD
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
12084P0800XPsychiatry Physician1929528MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OD029ALOTHERMNBCBS OF MN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31579489OTHERMNMEDICA

General Provider Information

NPI Number : 1306823232
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE ALICE ALBRECHT MD
Provider Business Mailing Address
First Line : 646 W BROADWAY
Second Line :
City : SUTTONS BAY
State : MI
Zip : 49682-9601
Country : US
Telephone Number : 952-215-2387
Fax Number :
Provider Business Practice Location Address
First Line : 1105 SIXTH ST
Second Line : MUNSON MEDICAL CENTER
City : TRAVERSE CITY
State : MI
Zip : 49684-2386
Country : US
Telephone Number : 231-935-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 01/31/2013

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