Individual
DR. DEANNA SUSAN MASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
24110 MEADOWBROOK RD, SUITE #100, NOVI, MI 48375-3459
(248) 987-1119
(248) 987-1118
Mailing address
24110 MEADOWBROOK RD, SUITE #100, NOVI, MI 48375-3459
(248) 987-1119
(248) 987-1118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301059342
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MI7278
MEDICARE PTAN
MI
Enumeration date
08/08/2006
Last updated
11/05/2014
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