# INDEPENDENT EMERGENCY PHYSICIANS P.C.

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

## Provider details

- **NPI number:** 1700136520
- **Authorized official:** JULIE SUSIN MBA (BUSINESS MANAGER)
- **Authorized official phone:** (248) 892-0715

## Contact information

- **Practice address:** 205 NORTH EAST AVENUE, EMERGENCY DEPARTMENT, JACKSON, MI 49201
- **Practice address phone:** (517) 788-4800
- **Mailing address:** PO BOX 100, ROYAL OAK, MI 48068-0100
- **Mailing address phone:** (248) 849-3137

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 1784233 | MI | Yes |

## Other

- **Enumeration date:** 09/19/2012
- **Last updated:** 09/19/2012