Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | ABMG2009104 | NC |
NPI | 1518279058 |
---|---|
Provider Name | Dr. Susan Michalowski |
First Address | Northville, MI 48167-1755 |
Second Address | Detroit, MI 48202-3429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2010 |
Last Update Date | 02/09/2011 |