Provider Demographics
NPI:1538473988
Name:BHULLAR, SUMAN PREET KAUR (MD)
Entity Type:Individual
Prefix:
First Name:SUMAN PREET
Middle Name:KAUR
Last Name:BHULLAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27450 SCHOENHERR RD STE 500
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6679
Mailing Address - Country:US
Mailing Address - Phone:586-582-7632
Mailing Address - Fax:586-582-7633
Practice Address - Street 1:27450 SCHOENHERR RD STE 500
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6679
Practice Address - Country:US
Practice Address - Phone:586-582-7632
Practice Address - Fax:586-582-7633
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301095976207Q00000X, 208M00000X
PAMD462427207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301095976OtherMICHIGAN DEPT OF COMMUNITY HEALTH, BUREAU OF HEALTH PROFESSIONS