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General NPI Number Information
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NPI Number | 1518279058
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Entity Type | Individual
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Provider Name | SUSAN MICHALOWSKI PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 09/02/2011
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Provider Practice Location Address
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Address Line | 440 BURROUGHS ST STE 446
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City | DETROIT
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State | MI
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Zip | 48202-3429
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Country | US
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Telephone | 313-870-1727
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Fax | 313-870-1701
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Provider Business Mailing Address
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Address Line | 20173 W WHIPPLE DR
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City | NORTHVILLE
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State | MI
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Zip | 48167-1755
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Country | US
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Telephone | 919-244-8148
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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 | 170100000X
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Taxonomy Name | Ph.D. Medical Genetics
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License Number | ABMG2009104
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License Number State | NC
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