Individual
FREDERIC C. SULAK JR.
Active
Individual
FREDERIC C. SULAK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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