Provider Demographics
NPI:1063047629
Name:SUZANNE A. LAW, D.O., P.C.
Entity type:Organization
Organization Name:SUZANNE A. LAW, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-884-5775
Mailing Address - Street 1:6158 AMBER LN
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7819
Mailing Address - Country:US
Mailing Address - Phone:248-884-5775
Mailing Address - Fax:
Practice Address - Street 1:G4007 W COURT ST STE E
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3560
Practice Address - Country:US
Practice Address - Phone:810-732-0908
Practice Address - Fax:810-732-1638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty