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General NPI Number Information
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NPI Number | 1437298049
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Entity Type | Organization
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Legal Business Name | SUZETTE SANCHEZ, DO DERMATOLOGY, PC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3290 N WELLNESS DR SUITE 260
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City | HOLLAND
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State | MI
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Zip | 49424-7261
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Country | US
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Telephone | 616-399-9040
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Fax | 616-399-0934
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Provider Business Mailing Address
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Address Line | 3290 N WELLNESS DR SUITE 260
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City | HOLLAND
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State | MI
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Zip | 49424-7259
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Country | US
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Telephone | 616-399-9040
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Fax | 616-399-0934
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUZETTE Q SANCHEZ
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Credential | D.O.
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Telephone | 616-399-9040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | SS012352
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License Number State | MI
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