Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 4301097124 | MI |
NPI | 1497960397 |
---|---|
Provider Name | Allison Meredith Jay |
First Address | Grosse Pointe Woods, MI 48236-2857 |
Second Address | Grosse Pointe Woods, MI 48236-2857 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 16/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0H208910 | BLUE CROSS (01) | MI |
1497960397 | (05) | MI |