Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | D0061444 | MD |
NPI | 1003868191 |
---|---|
Provider Name | Byron J Druzgal |
First Address | Spring Lake, MI 49456-2171 |
Second Address | Spring Lake, MI 49456-2171 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 03/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
405812700 | (05) | MD |
451601000 | (05) | MD |
I20939 | (02) | MD |
P00150017 | RAILROAD (01) | MD |