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General NPI Number Information
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NPI Number | 1518902576
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Entity Type | Individual
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Provider Name | SUSAN JEAN WILLIAMS D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 29140 BUCKINGHAM ST SUITE 1
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City | LIVONIA
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State | MI
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Zip | 48154-4482
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Country | US
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Telephone | 734-458-1455
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Fax | 734-458-1623
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Provider Business Mailing Address
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Address Line | 26068 GERMAN MILL RD
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City | FRANKLIN
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State | MI
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Zip | 48025-1138
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Country | US
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Telephone | 248-538-5398
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | SW008038
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License Number State | MI
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