Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4301095940 | MI |
Y | 111NI0900X | Internist | 4301095940 | MI |
N | 207R00000X | Internist | 88272 | OH |
N | 111NI0900X | Internist | 88272 | OH |
N | 208000000X | Pediatrician | 88272 | OH |
NPI | 1003030750 |
---|---|
Provider Name | Bretton Lee Schloesser |
First Address | Ann Arbor, MI 48105-9484 |
Second Address | Ypsilanti, MI 48197-1051 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 02/05/2017 |