Basic Information
| Provider Information | |||||||||
| NPI: | 1598774549 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUESS | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 43 | ||||||||
| Address2: | |||||||||
| City: | MASON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488540043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5176236260 | ||||||||
| FaxNumber: | 5176236460 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 E COLUMBIA ST | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | MASON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5172448950 | ||||||||
| FaxNumber: | 5172448951 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2006 | ||||||||
| LastUpdateDate: | 11/07/2007 | ||||||||
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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 | 208000000X | 4301074356 | MI | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.