Individual
MISS SUSAN MARIE KOGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1615 MICHIGAN AVE, BALDWIN, MI 49304-7984
(231) 745-4624
(231) 745-5031
Mailing address
4706 COOPER AVE, ROYAL OAK, MI 48073-1514
(248) 310-1270
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704139637
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
4704139637
MI
Other
Enumeration date
11/12/2010
Last updated
08/04/2021
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