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1649376922
SUPAK SOOKKASIKON
BLOOMFIELD TOWNSHIP, MI
NPI
1649376922
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MI 4301083253)
Enumeration Date
2006-09-15
Last Update Date
2014-02-28
Business Address
-- SUPAK SOOKKASIKON M.D.
4050 W MAPLE RD SUITE 101
BLOOMFIELD TOWNSHIP, MI 48301-3148
Phone number: 248-885-8211
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Mailing Address
-- SUPAK SOOKKASIKON M.D.
4050 W MAPLE RD SUITE 101
BLOOMFIELD TOWNSHIP, MI 48301-3148
Phone number: 248-885-8211
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