Individual
FREDERIC C. SULAK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
WYANDOTTE HOSPITAL, 2333 BIDDLE, WYANDOTTE, MI 48192
(734) 246-7101
(734) 324-3615
Mailing address
WYANDOTTE HOSPITAL, 2333 BIDDLE, WYANDOTTE, MI 48192
(734) 246-7101
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
405362
MI
207RC0000X
Cardiovascular Disease Physician
Primary
4301405362
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060H264410
BLUE CROSS-BLUE CROSS
—
05
—
286419010
—
MI
01
—
FS405362
CHAMPUS-CHAMPUS
—
Enumeration date
12/01/2006
Last updated
04/11/2024
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