Healthcare Provider Details

I. General information

NPI: 1154718237
Provider Name (Legal Business Name): SUZANNE JEANNE HUBERTY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZANNE JEANNE MCCARTNEY M.D.

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 11/08/2025
Certification Date: 11/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 SHAFFER ST STE 10
KALAMAZOO MI
49048-1629
US

IV. Provider business mailing address

7950 MOORSBRIDGE RD STE 304
PORTAGE MI
49024-4420
US

V. Phone/Fax

Practice location:
  • Phone: 269-337-6373
  • Fax:
Mailing address:
  • Phone: 269-222-2109
  • Fax: 800-350-5021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number4301502131
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: