Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 4301093769 | MI |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 4301093769 | MI |
N | 207NS0135X | Procedural Dermatology | 4301093769 | MI |
NPI | 1104089747 |
---|---|
Provider Name | Dr. Alison Bates Durham |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2008 |
Last Update Date | 19/10/2020 |