Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 10306 | MT |
NPI | 1164469730 |
---|---|
Provider Name | Andrew C Michel |
First Address | Norman, OK 73070-5270 |
Second Address | Helena, MT 59601-4928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
058656 | (05) | MT |
G49378 | (02) | MT |