| Doctor Name: | PHYLLIS A SURMA |
| NPI Number: | 1003068222 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 4704146111 |
| Business Practice Address: | 28050 Grand River Ave Tracc Farmington Hills, MI - 483365919 |
| Business Phone Number: | 2484718000 |
| Business Fax Number: | |
| Mailing Address: | 28050 Grand River Ave, Tracc FARMINGTON HILLS |
| State: | MI |
| Postal Code: | 483365919 |
| Phone Number: | 2484718000 |
| Fax Number: | |
| NPI Enumeration Date: | 10/21/2008 |
| NPI Last Update Date: | 10/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | 4704146111 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |