Organization
SUSAN A. RADTKE, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN ANNE RADTKE MD (PRESIDENT)
(586) 776-0797
Entity
Organization
Contact information
Practice address
21321 HARPER AVE, SUITE A, SAINT CLAIR SHORES, MI 48080-2243
(586) 776-0797
(586) 776-4910
Mailing address
21321 HARPER AVE, SUITE A, SAINT CLAIR SHORES, MI 48080-2243
(586) 776-0797
(586) 776-4910
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0500301
BCBS
—
Enumeration date
05/23/2008
Last updated
04/24/2012
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