Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 5101010948 | MI |
NPI | 1093743007 |
---|---|
Provider Name | Dr. Amy Lum Tobin |
First Address | Sterling Heights, MI 48310-3210 |
Second Address | Sterling Heights, MI 48310-3210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 20/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0H26347 | BCBS (01) | MI |
3290719/11 | (05) | MI |
G38020 | (02) | MI |