Basic Information
| Provider Information | |||||||||
| NPI: | 1518019397 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SULISZ | ||||||||
| FirstName: | CHERYL | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD, MPH, MS, FACOEM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11700 METRO AIRPORT CENTER DR. | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | ROMULUS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48174 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349557000 | ||||||||
| FaxNumber: | 7349557006 | ||||||||
| Practice Location | |||||||||
| Address1: | 11700 METRO AIRPORT CENTER DR STE 104 | ||||||||
| Address2: | |||||||||
| City: | ROMULUS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481741404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349557000 | ||||||||
| FaxNumber: | 7349557006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2007 | ||||||||
| LastUpdateDate: | 08/09/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083X0100X | 4301051486 | MI | N | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine | 2083P0500X | 4301051486 | MI | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Preventive Medicine/Occupational Environmental Medicine |
No ID Information.