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NPI Code Detail

MEDICARE: JON MICHAEL SUVADA

MEDICARE: JON MICHAEL SUVADA
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1326900259
Entity Type Code : Individual
Provider Name (Legal Business Name) : JON MICHAEL SUVADA
Provider Business Mailing Address
First Line : 415 HANNAH ST
Second Line :
City : ROSCOMMON
State : MI
Zip : 48653-8311
Country : US
Telephone Number : 989-281-1128
Fax Number :
Provider Business Practice Location Address
First Line : PO BOX 392
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49685-0392
Country : US
Telephone Number : 231-268-0007
Fax Number : 231-525-3170
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2025
Last Update Date : 12/01/2025

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Directions to “ JON MICHAEL SUVADA ” Practice Location

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