Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 5101014108 | MI |
Y | 2080P0204X | Pediatric Emergency Doctor | 5101014108 | MI |
NPI | 1275618241 |
---|---|
Provider Name | Athina Sikavitsas |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 18/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4374241 | (05) | MI |
G84897 | (02) | MI |