Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 5101011076 | MI |
NPI | 1134133762 |
---|---|
Provider Name | Dr. Andrea Amalfitano |
First Address | East Lansing, MI 48824-7015 |
Second Address | Okemos, MI 48864 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 12/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1134133762 | (05) | MI |
4891301 | (05) | MI |
F44809 | (02) |