Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 4301073359 | MI |
NPI | 1003817594 |
---|---|
Provider Name | Andrew Dean Scrogin |
First Address | Ann Arbor, MI 48105-9484 |
Second Address | Rochester Hills, MI 48309-3868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 05/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1102803611 | BLUE CROSS BLUE SHIELD (01) | MI |
F92560 | (02) | MI |