Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Supak Sookkasikon, MD

Individual provider Family Medicine Physician · NPI 1649376922

Supak Sookkasikon, MD is a Family Practice in Bloomfield Township, Michigan. Qualified in 2003, 23 years ago. Practices with A3 Medical, a 2-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
23
Licensed in
MI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4050 W Maple Rd Ste 101
Bloomfield Township, MI 48301-3148
Phone: (248) 885-8211
Fax: (248) 885-8357
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 4301083253 (MI)

Record details

NPI number1649376922
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedSeptember 15, 2006
Last updated in NPPESFebruary 28, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice A3 Medical — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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