Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 2901015347 | MI |
NPI | 1154545333 |
---|---|
Provider Name | Mrs. Susan Beverly Paurazas |
First Address | Sterling Heights, MI 48314 |
Second Address | Sterling Heights, MI 48314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |