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General NPI Number Information
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NPI Number | 1134018955
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Entity Type | Individual
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Provider Name | SUYIN BALLARD PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 30488 MILFORD RD
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City | NEW HUDSON
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State | MI
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Zip | 48165-8583
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Country | US
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Telephone | 248-437-4625
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Fax |
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Provider Business Mailing Address
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Address Line | 1665 COLE ST
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City | BIRMINGHAM
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State | MI
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Zip | 48009-7056
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Country | US
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Telephone | 303-269-1827
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601013113
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License Number State | MI
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