Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 4301067577 | MI |
NPI | 1023073053 |
---|---|
Provider Name | Claudell Cox |
First Address | Wyoming, MI 49509-4395 |
Second Address | Wyoming, MI 49509-4395 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H55860 | (02) | MI |