Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 4301062545 | MI |
NPI | 1124026075 |
---|---|
Provider Name | Dr. Andrew M Duda |
First Address | Lansing, MI 48910-2898 |
Second Address | Lansing, MI 48910-2898 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 01/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1124026075 | (05) | MI |
C33255 | (02) | MI |