Individual
DR. SUZANNE R WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-3000
Mailing address
23701 WILMARTH ST, FARMINGTON, MI 48335-3566
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301053729
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301053729
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102745734
—
MI
05
—
102745743
—
MI
01
—
SW053729
BC/BS OF MI
MI
Enumeration date
03/21/2006
Last updated
06/17/2010
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