Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 4301084786 | MI |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 4301084786 | MI |
NPI | 1285655753 |
---|---|
Provider Name | Clayton Austin Peimer |
First Address | Carol Stream, IL 60122-0021 |
Second Address | Marquette, MI 49855-2675 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 21/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4908211 | (05) | MI |
B36064 | (02) |