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1235116229

NPI Code Detail

MEDICARE: FRANK J SUSLAVICH M.D.

MEDICARE: FRANK J SUSLAVICH M.D.

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
1	2085B0100X	Body Imaging Physician	33348	MN
2	2085N0700X	Neuroradiology Physician	33348	MN
3	2085N0904X	Nuclear Radiology Physician	33348	MN
4	2085P0229X	Pediatric Radiology Physician	33348	MN
5	2085R0203X	Therapeutic Radiology Physician	33348	MN
6	2085R0204X	Vascular & Interventional Radiology Physician	33348	MN
7	2085U0001X	Diagnostic Ultrasound Physician	33348	MN
8	2085R0202X	Diagnostic Radiology Physician	33348	MN

Other Identifiers

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

General Provider Information

NPI Number	:	1235116229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK J SUSLAVICH M.D.

Provider Business Mailing Address
First Line	:	23 W CENTRAL ENTRANCE # 160
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55811-3433
Country	:	US
Telephone Number	:	218-722-3700
Fax Number	:	218-722-8705

Provider Business Practice Location Address
First Line	:	750 E 34TH ST
Second Line	:
City	:	HIBBING
State	:	MN
Zip	:	55746-2341
Country	:	US
Telephone Number	:	218-262-4881
Fax Number	:	218-362-6699

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	06/23/2021

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Directions to “ FRANK J SUSLAVICH M.D.” Practice Location

Language	Start Address	Practice Location

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