Hickenbottom, Susan L

Hickenbottom, Susan L is an individual health care provider with primary practice located at 5333 Mcauley Dr Suite 6109, Ypsilanti MI 48197-1014. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Hickenbottom, Susan L can be contacted via phone (734) 712-1400.

Contact Information

Primary practice address
5333 Mcauley Dr Suite 6109 Ypsilanti MI 48197-1014
Phone: (734) 712-1400
Fax: (734) 712-1670
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 4301061696 Michigan

Profile Details

NPI number 1770532715
LBN Legal business name Hickenbottom, Susan L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2006
Last updated Sep 25th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770532715 NPPES
Michigan MEDICAID 3473559

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