Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RX0202X | Medical Oncology | 01038593 | IN |
NPI | 1134111230 |
---|---|
Provider Name | David M Loesch |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 03/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100323440 | (05) | IN |
B54647 | (02) |