Provider Demographics
NPI:1104379601
Name:WOSIK, SUSAN (PA-C)
Entity Type:Individual
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First Name:SUSAN
Middle Name:
Last Name:WOSIK
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:26850 PROVIDENCE PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1261
Mailing Address - Country:US
Mailing Address - Phone:248-662-4110
Mailing Address - Fax:248-662-4120
Practice Address - Street 1:11900 E 12 MILE RD STE 100
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3487
Practice Address - Country:US
Practice Address - Phone:248-662-4110
Practice Address - Fax:248-662-4120
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2023-10-09
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical