Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 5101015001 | MI |
NPI | 1003856972 |
---|---|
Provider Name | Christopher Jonathan Hummel |
First Address | Detroit, MI 48267-3397 |
Second Address | Muskegon, MI 49444-1849 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 19/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
114722579 | (05) | MI |
114735110 | (05) | MI |
CH015001 | BCBS (01) | |
I03512 | (02) |