Individual
SUZANNE ANGOBUNG BERNAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
4704255720
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704255720
OTHERS
MI
Enumeration date
09/12/2022
Last updated
09/12/2022
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