MEDICARE: SUDAD LOUIS MD PLLC

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1972945616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUDAD LOUIS MD PLLC

Provider Business Mailing Address
First Line	:	39150 DEQUINDRE RD STE 200
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-6983
Country	:	US
Telephone Number	:	586-268-5440
Fax Number	:	586-268-5441

Provider Business Practice Location Address
First Line	:	39150 DEQUINDRE RD STE 200
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-6983
Country	:	US
Telephone Number	:	586-268-5440
Fax Number	:	586-268-5441

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SUDAD LOUIS
Credential	:	M.D.
Telephone Number	:	248-798-4797

Provider Enumeration Date	:	07/23/2013
Last Update Date	:	01/26/2019

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