Individual provider Active NPI

Susan Dale Charlamb, MD

  • Psychiatry Physician
  • W Bloomfield, MI
National Provider Identifier
1396826418
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301043021 Issued in MI
Practice address
5600 W Maple Rd
Suite C-304
W Bloomfield, MI 48322-3704
Phone
(248) 855-5540
NPI assigned
Oct 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301043021 MI Primary

Addresses

Primary practice location

5600 W Maple Rd
Suite C-304
W Bloomfield, MI 48322-3704

Mailing address

5600 W Maple Rd
Suite C-304
W Bloomfield, MI 48322-3704
Phone (248) 855-5540

Other identifiers 1

IdentifierTypeStateIssuer
2606308890OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070213000176 MI Practitioner - Psychiatry 4880696343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Albany Medical College of Union University, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5600 W Maple Rd
Suite C304
West Bloomfield, MI 48322-3700
Phone (248) 855-5540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Susan D Charlamb M D P C Psychiatry CurrentSince Jul 1, 1996 Accepting new patients

Locations

5600 W Maple Rd
Ste C304
West Bloomfield, MI 48322
Phone (248) 855-5540

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396826418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 W MAPLE RD",
            "address_2": "SUITE C-304",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223704",
            "telephone_number": "248-855-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 W MAPLE RD",
            "address_2": "SUITE C-304",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223704",
            "telephone_number": "248-855-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLAMB",
        "first_name": "SUSAN",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301043021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2606308890",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in W Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.