Kathryn H. Sussman, M.D. P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

KATHRYN H. SUSSMAN, M.D. P.C.

Practice address

28800 Ryan Rd
Suite 320
Warren, MI 48092-4272

Phone

(586) 573-4980

Fax

(586) 573-0640

NPI assigned

May 3, 2007

Last updated

Dec 11, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kathryn H Sussman, M.D.

Title

President

Phone

(586) 573-4980

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1720290943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28800 RYAN RD",
            "address_2": "SUITE 320",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924272",
            "telephone_number": "586-573-4980",
            "fax_number": "586-573-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28800 RYAN RD",
            "address_2": "SUITE 320",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924272",
            "telephone_number": "586-573-4980",
            "fax_number": "586-573-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHRYN H. SUSSMAN, M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "SUSSMAN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-573-4980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "KS050808",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "0E06271",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUE SHIELD",
            "identifier": "0705037252",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doaa Kassem, LLMSW
• Ramzi Kassem, PHARMD
• Karam Kassir, DDS
• Steve Katchi
• Katherine L Boyd M D P C
• Michelle Katimi
• Shurouk Kattan Rahmani, MD
• Baruch Katz, M.D.
• Heather Lynn Kauffman, PHARMACIST
• Joseph William Kaufman, M.D.

• Dermatology Physician in Warren, MI
• Providers in Warren, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.