Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 4301081232 | MI |
NPI | 1043251333 |
---|---|
Provider Name | Dr. Ann Marsh-Senic |
First Address | Royal Oak, MI 48067-3972 |
Second Address | Southfield, MI 48075-4818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AM081232 | BC/BS OF MICHIGAN (01) | MI |
H98846 | (02) | MI |