Individual
STEVEN SUSLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5215 HOLY CROSS PKWY, EMERGENCY DEPARTMENT, MISHAWAKA, IN 46545-1469
(574) 335-5000
Mailing address
3371 CLEVELAND ROAD EXT, SUITE 210, SOUTH BEND, IN 46628-9780
(574) 271-2558
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01043107
IN
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
01043107
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000181696
ANTHEM
IN
05
—
100461010A
—
IN
05
—
104340118
—
MI
01
—
930101008
RAIL ROAD MEDICARE
IN
Enumeration date
04/06/2006
Last updated
11/17/2011
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