Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 4301069964 | MI |
NPI | 1053458117 |
---|---|
Provider Name | Adam Benjamin Agranoff |
First Address | Chelsea, MI 48118-1801 |
Second Address | Chelsea, MI 48118-1801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 20/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131672 | CARE CHOICES (01) | |
AA069964 | BCBS (01) | |
C7692 | MCARE (01) | |
H35085 | (02) | MI |