Active NPI
Susheel K Vij, PHARMACIST
- Pharmacist
- Mount Clemens, MI
National Provider Identifier
1013286475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302028316
- Practice address
- 215 North Ave
Suite 200
Mount Clemens, MI 48043-1716 - Phone
- (586) 307-9015
- NPI assigned
- Dec 14, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302028316 | MI | Primary |
Addresses
Primary practice location
215 North Ave
Suite 200
Mount Clemens, MI 48043-1716
Mailing address
4921 River Bank Court
Troy, MI 48085
Phone (248) 635-4728
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302028316 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323820800000",
"number": "1013286475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4921 RIVER BANK COURT",
"city": "TROY",
"state": "MI",
"postal_code": "48085",
"telephone_number": "248-635-4728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 NORTH AVE",
"address_2": "SUITE 200",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480431716",
"telephone_number": "586-307-9015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIJ",
"first_name": "SUSHEEL",
"middle_name": "K",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-14",
"last_updated": "2011-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302028316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Clemens, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.