Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 5101018391 | MI |
NPI | 1003045022 |
---|---|
Provider Name | Arthur Harvey Donahue |
First Address | Lakewood, CO 80401-3267 |
Second Address | Lakewood, CO 80401-3267 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2009 |
Last Update Date | 11/07/2017 |