Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 4301038089 | MI |
Y | 207PE0004X | Emergency Medical Services | 4301038089 | MI |
N | 207Q00000X | Family Doctor | 4301038089 | MI |
NPI | 1023060316 |
---|---|
Provider Name | Bryant W Pierce |
First Address | Chicago, IL 60689-5325 |
Second Address | Grand Rapids, MI 49506-2921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 27/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
930080725 | RAILROAD MEDICARE (01) | MI |
D83102 | (02) | MI |