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
Mailing address4050 W Maple Rd, Suite 101, Bloomfield Township, MI 48301-3148

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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