Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207ND0900X | Dermatopathologist | 4301074949 | MI |
NPI | 1669421145 |
---|---|
Provider Name | Aleodor Alexandru Andea |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 11/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009936902 | (05) | AL |
009936903 | (05) | AL |
009937603 | (05) | AL |
051534579 | BCBS (01) | AL |
051534581 | BCBS (01) | AL |
051535431 | BCBS (01) | AL |