MEDICARE: DR. SUZAN MOKHAYESH SYED MD

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	207Q00000X	Family Medicine Physician	4301081351	MI

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

General Provider Information

NPI Number	:	1992899827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUZAN MOKHAYESH SYED MD

Provider Business Mailing Address
First Line	:	2300 HAGGERTY RD STE 2140
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-2191
Country	:	US
Telephone Number	:	248-669-5050
Fax Number	:	248-669-1700

Provider Business Practice Location Address
First Line	:	2300 HAGGERTY RD STE 2140
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-2191
Country	:	US
Telephone Number	:	248-669-5050
Fax Number	:	248-669-1700

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	12/01/2016

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