Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 4301078276 | MI |
N | 207XS0106X | Orthopaedic Hand Surgeon | R-7861 | IA |
NPI | 1255549895 |
---|---|
Provider Name | Danielle A Conaway |
First Address | Traverse City, MI 49684-2236 |
Second Address | Traverse City, MI 49684-2236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 22/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0B81023 | BCBSM (01) | MI |
105205575 | (05) | MI |