Provider Demographics
NPI:1093724783
Name:ANDREWS, SUSAN GOOD (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:GOOD
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1640 HASLETT RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-8691
Mailing Address - Country:US
Mailing Address - Phone:517-575-0501
Mailing Address - Fax:517-575-0503
Practice Address - Street 1:1640 HASLETT RD
Practice Address - Street 2:SUITE 1
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-8691
Practice Address - Country:US
Practice Address - Phone:517-575-0501
Practice Address - Fax:517-575-0503
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301042652208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB46422Medicare UPIN