Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 4301077972 | MI |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 4301077972 | MI |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 4301077972 | MI |
NPI | 1033201926 |
---|---|
Provider Name | Christine Theresa Cigolle |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ypsilanti, MI 48198-5753 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 06/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4696094 | (05) | MI |
F43881 | (02) | MI |