Most Relevant Information
Provider Data
| NPI Number: | 1003312364 |
| Provider Name: | SUSAN MASSOUD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 5302042007 |
Most Important Dates
| Enumeration Date: | 04/04/2018 |
| Last Updated: | 02/02/2019 |
Provider Practice Location
33201 VAN DYKE AVE
STERLING HEIGHTS
MI
483125924
Practice Location Phone/Fax
| Phone: | 5869398171 |
| Fax: |
Provider Mailing Location
33201 VAN DYKE AVE
STERLING HEIGHTS
MI
483125924
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |