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Individual

DAVID SUSEWITZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2644 W JEFFERSON AVE, TRENTON, MI 48183-2803
(734) 675-4060
Mailing address
2644 W JEFFERSON AVE, TRENTON, MI 48183-2803
(734) 675-4060

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
900H21185
BLUE CROSS
MI
Enumeration date
01/16/2007
Last updated
02/22/2008
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