Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 2901018881 | MI |
N | 213EG0000X | General Practice | 2901018881 | MI |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 2901018881 | MI |
NPI | 1114144581 |
---|---|
Provider Name | Amy Man-Wai Chin |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 13/04/2020 |