Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301056075 | MI |
N | 111NI0900X | Internist | 4301056075 | MI |
N | 207RC0200X | Critical Care Medicine | 4301056075 | MI |
Y | 207RP1001X | Pulmonary Disease | 4301056075 | MI |
NPI | 1043392954 |
---|---|
Provider Name | Douglas Allen Arenberg |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 10/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3303432 | (05) | MI |
G36792 | (02) | MI |