Provider Demographics
NPI:1043445364
Name:SUZUKI, MICHIKO (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MICHIKO
Middle Name:
Last Name:SUZUKI
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 W WALNUT ST
Mailing Address - Street 2:R2 E202
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5188
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:950 W WALNUT ST
Practice Address - Street 2:R2 E202
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5188
Practice Address - Country:US
Practice Address - Phone:317-274-7453
Practice Address - Fax:317-274-8575
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-17
Last Update Date:2009-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11014744A390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program