Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 4301108760 | MI |
N | 207N00000X | Dermatologist | 200300521 | NC |
Y | 207N00000X | Dermatologist | 4301108760 | MI |
NPI | 1023128758 |
---|---|
Provider Name | Dr. Susan Riggs Runge |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 15/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A58178 | (02) | NC |