# SUBURBAN OCCUPATIONAL HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366988438
- **Authorized official:** JAMES SISKOSKY D.O (CFO)
- **Authorized official phone:** (734) 728-4445

## Contact information

- **Practice address:** 29750 ECORSE RD, ROMULUS, MI 48174-3528
- **Practice address phone:** (734) 728-4445
- **Practice address fax:** (734) 728-4442
- **Mailing address:** 29750 ECORSE RD, ROMULUS, MI 48174-3528

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | 1841318029 | MI | — |
| 261QX0100X | Occupational Medicine Clinic/Center | 1962523308 | MI | Yes |

## Other

- **Enumeration date:** 01/13/2017
- **Last updated:** 01/13/2017