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NPI Code Detail

MEDICARE: FRANK I SUSSER DO

MEDICARE: FRANK I SUSSER DO
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
1207RC0000XCardiovascular Disease Physician34-00-7133OH

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 : 1396805453
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRANK I SUSSER DO
Provider Business Mailing Address
First Line : PO BOX 1239
Second Line :
City : TROY
State : MI
Zip : 48099-1239
Country : US
Telephone Number : 248-824-6600
Fax Number : 248-324-1477
Provider Business Practice Location Address
First Line : 355 E CAMPUS VIEW BLVD
Second Line : SUITE 180
City : COLUMBUS
State : OH
Zip : 43235-5680
Country : US
Telephone Number : 248-824-6299
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 11/15/2013

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