Kasko, Susan

Kasko, Susan is an individual health care provider with primary practice located at 6701 Paw Paw Ave , Coloma MI 49038-9519. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Kasko, Susan can be contacted via phone (269) 463-3600.

Contact Information

Primary practice address
6701 Paw Paw Ave Coloma MI 49038-9519
Phone: (269) 463-3600
Fax: (269) 468-3334
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101022893 Michigan

Profile Details

NPI number 1609219070
LBN Legal business name Kasko, Susan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2013
Last updated Oct 20th, 2016 - about 10 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 1609219070 NPPES
Michigan MEDICAID 1609219070

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