Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 4301057086 | MI |
NPI | 1023016474 |
---|---|
Provider Name | Dr. Aris Querol Urbanes |
First Address | Grosse Pointe Park, MI 48230-1448 |
Second Address | Detroit, MI 48201-2017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2005 |
Last Update Date | 07/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03723038 | ECFMG (01) | |
4301057086 | CONTROLLED SUBSTANCE (01) | MI |
BU2473623 | FEDERAL DEA (01) |