Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SUPAK SOOKKASIKON, M.D.
Active Sole ProprietorSUPAK SOOKKASIKON, M.D. is a Family Medicine healthcare provider located in BLOOMFIELD TOWNSHIP, Michigan. NPI 1649376922 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · BLOOMFIELD TOWNSHIP, MI
Registration Details
- NPI Number
- 1649376922
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 15, 2006 (19.903163724548 yrs)
- Last Updated
- Feb 28, 2014
- License
-
4301083253 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4050 W MAPLE RDSUITE 101BLOOMFIELD TOWNSHIP, MI, 483013148Browse MI providers · Browse ZIP 48301
- Phone
- 2488858211
- Fax
- 2488858357
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in BLOOMFIELD TOWNSHIP, MI
| Name | Credential | NPI |
|---|---|---|
| DR. KIMBERLY H THOMPSON | MD | 1659352409 |
| DANIEL MERAM | M.D. | 1215354493 |
| TARA MAHER ELIA | MD | 1497375166 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.