Healthcare Provider Details

I. General information

NPI: 1972014074
Provider Name (Legal Business Name): SUHAD YALDO MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2017
Last Update Date: 10/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30701 WOODWARD AVE. SUITE S-301
ROYAL OAK MI
48073
US

IV. Provider business mailing address

30701 WOODWARD AVE SUITE S-301
ROYAL OAK MI
48073
US

V. Phone/Fax

Practice location:
  • Phone: 248-541-2222
  • Fax: 248-541-7734
Mailing address:
  • Phone: 248-541-2222
  • Fax: 248-541-7734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301076166
License Number StateMI

VIII. Authorized Official

Name: DR. SUHAD YALDO
Title or Position: OWNER
Credential: MD
Phone: 248-229-9380