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General NPI Number Information
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NPI Number | 1093700247
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Entity Type | Individual
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Provider Name | SUSAN HANSON KLEMMER M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 6080 DIXIE HWY SUITE B
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City | CLARKSTON
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State | MI
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Zip | 48346-3493
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Country | US
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Telephone | 248-623-9700
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Fax | 248-623-8996
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Provider Business Mailing Address
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Address Line | 6080 DIXIE HWY SUITE B
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City | CLARKSTON
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State | MI
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Zip | 48346-3493
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Country | US
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Telephone | 248-623-9700
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Fax | 248-623-8996
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | SK042375
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License Number State | MI
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