Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 2901020980 | MI |
Y | 213EG0000X | General Practice | 2901020980 | MI |
NPI | 1003254285 |
---|---|
Provider Name | Alexander Thomas Marlow |
First Address | Ann Arbor, MI 48108-1410 |
Second Address | Ann Arbor, MI 48104-5156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2013 |
Last Update Date | 14/10/2020 |