Individual
MR. DEREK ROBERT SURO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
6312 BRENDA DR, CASS CITY, MI 48726-1002
(810) 705-0353
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006751
MI
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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