Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 4301047722 | MI |
NPI | 1457320228 |
---|---|
Provider Name | David Aughton |
First Address | Troy, MI 48083-1103 |
Second Address | Royal Oak, MI 48073-6710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 26/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1916194 | (05) | MI |
350F361320 | BCBSM (01) | MI |
F06149 | (02) | MI |