Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 4301034480 | MI |
NPI | 1093813180 |
---|---|
Provider Name | Anton Strocel |
First Address | Flint, MI 48503-5004 |
Second Address | Flint, MI 48503-5004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B44214 | (02) | MI |