Individual
MR. MICHAEL DAVID SUSALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 GREEN RD STE 300, ANN ARBOR, MI 48105-1575
(800) 466-3764
Mailing address
2000 GREEN RD STE 300, ANN ARBOR, MI 48105-1575
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301109326
MI
Other
Enumeration date
04/27/2012
Last updated
08/15/2017
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