Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 5101007896 | MI |
N | 207VX0000X | Obstetrician | CD007896 | MI |
NPI | 1205843752 |
---|---|
Provider Name | Cheryl Dwyer |
First Address | Midland, MI 48640 |
Second Address | Midland, MI 48640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 01/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A76250 | (02) | MI |