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General NPI Number Information
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NPI Number | 1093648420
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Entity Type | Individual
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Provider Name | SUZIE DAVTYAN
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Gender | Female
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Dates
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Enumeration Date | 06/05/2026
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Last Update Date | 06/05/2026
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Provider Practice Location Address
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Address Line | 7300 N CANTON CENTER RD
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City | CANTON
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State | MI
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Zip | 48187-1579
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Country | US
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Telephone | 734-454-8001
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Fax |
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Provider Business Mailing Address
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Address Line | 33155 ANNAPOLIS ST
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City | WAYNE
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State | MI
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Zip | 48184-2405
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 5951001606
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License Number State | MI
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