Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 4301069431 | MI |
NPI | 1144214990 |
---|---|
Provider Name | Bernard Degnan |
First Address | Detroit, MI 48236-2169 |
Second Address | Royal Oak, MI 48073-6770 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2005 |
Last Update Date | 21/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3366639 | (05) | MI |
G49353 | (02) |