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General NPI Number Information
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NPI Number | 1720828049
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Entity Type | Individual
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Provider Name | SUHA AHMED OD
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Gender | Female
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Dates
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Enumeration Date | 05/27/2024
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Last Update Date | 05/27/2024
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Provider Practice Location Address
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Address Line | 40895 ANN ARBOR RD E
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City | PLYMOUTH
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State | MI
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Zip | 48170-4448
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Country | US
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Telephone | 734-233-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 49254 DOMINION CT
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City | CANTON
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State | MI
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Zip | 48187-5807
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Country | US
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Telephone | 734-620-5016
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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 | 4901005791
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License Number State | MI
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