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General NPI Number Information
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NPI Number | 1285417469
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Entity Type | Individual
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Provider Name | TALHA SUHAIL O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 22395 EUREKA RD
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City | TAYLOR
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State | MI
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Zip | 48180-6016
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Country | US
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Telephone | 734-324-0996
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 BONADONNA CRT
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City | WINDSOR
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State | ONTARIO
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Zip | N9E4Y4
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Country | CA
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901005721
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License Number State | MI
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