Provider Demographics
NPI:1215034525
Name:TOBIN, SUE C (DO)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:C
Last Name:TOBIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:C
Other - Last Name:KULINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1447 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4727
Mailing Address - Country:US
Mailing Address - Phone:989-583-4114
Mailing Address - Fax:989-583-1349
Practice Address - Street 1:5400 MACKINAW RD
Practice Address - Street 2:5 TH FLOOR
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9515
Practice Address - Country:US
Practice Address - Phone:989-583-5060
Practice Address - Fax:989-583-5097
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0049170207RX0202X
CODR-49170207RH0003X
MI5101013923207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH96609Medicare UPIN
COCOA104656Medicare PIN