Organization
SUBURBAN OCCUPATIONAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES SISKOSKY D.O (CFO)
(734) 728-4445
Entity
Organization
Contact information
Practice address
29750 ECORSE RD, ROMULUS, MI 48174-3528
(734) 728-4445
(734) 728-4442
Mailing address
29750 ECORSE RD, ROMULUS, MI 48174-3528
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
1841318029
MI
261QX0100X
Occupational Medicine Clinic/Center
Primary
1962523308
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508913047
NPI
MI
01
—
1841318029
NPI
MI
01
—
1962523308
NPI
MI
Enumeration date
01/13/2017
Last updated
01/13/2017
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