Provider Demographics
NPI:1669598454
Name:KRUPIN-CARTER, SUSAN CHRISTIE (MT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:CHRISTIE
Last Name:KRUPIN-CARTER
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-3801
Mailing Address - Country:US
Mailing Address - Phone:743-414-7669
Mailing Address - Fax:734-414-7679
Practice Address - Street 1:44670 ANN ARBOR RD W
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-3962
Practice Address - Country:US
Practice Address - Phone:734-414-7669
Practice Address - Fax:734-414-7679
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist