| Doctor Name: | SUSAN GAYLE WIERS |
| NPI Number: | 1497715130 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 4704135893 |
| Business Practice Address: | 35050 23 Mile Rd Suite B New Baltimore, MI - 480473606 |
| Business Phone Number: | 5867250477 |
| Business Fax Number: | 5867258835 |
| Mailing Address: | 43750 Garfield Rd, Suite 104 CLINTON TWP |
| State: | MI |
| Postal Code: | 480381135 |
| Phone Number: | 5862266865 |
| Fax Number: | 5862266880 |
| NPI Enumeration Date: | 03/25/2006 |
| NPI Last Update Date: | 05/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | 4704135893 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |