Individual
SUSAN A RADTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21321 HARPER, SUITE A, ST. CLAIR SHORES, MI 48080
(586) 776-0797
(586) 776-4910
Mailing address
21321 HARPER, SUITE A, ST. CLAIR SHORES, MI 48080
(586) 776-0797
(586) 776-4910
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
038554
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2912609
—
MI
Enumeration date
08/04/2006
Last updated
07/08/2007
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