Provider Demographics
NPI:1720089907
Name:SANCHEZ, SUZETTE (DO)
Entity Type:Individual
Prefix:
First Name:SUZETTE
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3290 N WELLNESS DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-7259
Mailing Address - Country:US
Mailing Address - Phone:616-399-9040
Mailing Address - Fax:
Practice Address - Street 1:3290 N WELLNESS DR
Practice Address - Street 2:SUITE 260
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-7259
Practice Address - Country:US
Practice Address - Phone:616-399-9040
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012352207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology