Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 4301111630 | MI |
N | 207YS0123X | Facial Plastic Surgeon | 4301111630 | MI |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 4301111630 | MI |
NPI | 1669738324 |
---|---|
Provider Name | Andrew William Joseph |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Livonia, MI 48152-1054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2012 |
Last Update Date | 19/12/2018 |