Provider Demographics
NPI:1316205875
Name:DUPLER, SUZANNE PETRINA (DO)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:PETRINA
Last Name:DUPLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1540 E HOSPITAL DR
Mailing Address - Street 2:SPC 4245
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-4000
Mailing Address - Country:US
Mailing Address - Phone:734-763-2435
Mailing Address - Fax:734-763-6651
Practice Address - Street 1:1540 E HOSPITAL DR
Practice Address - Street 2:SPC 4245
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-4000
Practice Address - Country:US
Practice Address - Phone:734-763-2435
Practice Address - Fax:734-763-6651
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
CA20A15537207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program