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NPI Code Detail

MEDICARE: WILMAR SUAN

MEDICARE: WILMAR SUAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225500000XRespiratory/Developmental/Rehabilitative Specialist/Technologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043786874
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILMAR SUAN
Provider Business Mailing Address
First Line : 33150 SCHOOLCRAFT RD
Second Line :
City : LIVONIA
State : MI
Zip : 48150-1646
Country : US
Telephone Number : 734-513-2731
Fax Number :
Provider Business Practice Location Address
First Line : 3290 W BIG BEAVER RD STE 510
Second Line :
City : TROY
State : MI
Zip : 48084-2917
Country : US
Telephone Number : 734-513-2731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2018
Last Update Date : 08/19/2021

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Directions to “ WILMAR SUAN ” Practice Location

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