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NPI Code Detail

MEDICARE: SUSAN BETH TAM DO

MEDICARE:   SUSAN BETH TAM  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
1207Q00000XFamily Medicine Physician5010013747MI

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 : 1801873237
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN BETH TAM DO
Provider Business Mailing Address
First Line : 18000 W 9 MILE RD
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48075-4009
Country : US
Telephone Number : 248-336-4000
Fax Number : 248-336-9137
Provider Business Practice Location Address
First Line : 911 E 9 MILE RD
Second Line :
City : FERNDALE
State : MI
Zip : 48220-1934
Country : US
Telephone Number : 248-336-4000
Fax Number : 248-336-9137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 12/16/2025

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Directions to “ SUSAN BETH TAM DO” Practice Location

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