NPI | 1922248772 |
---|---|
Entity Type | Organization |
Authorized Contact | BETTY ELLER Credentialing 231-672-2120 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
207RG0100X Internal Medicine, Gastroenterology | |
207RI0200X Internal Medicine, Infectious Disease | |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2009-03-05 |
Last Update Date | 2023-09-28 |