Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 4301093983 | MI |
N | 207Q00000X | Family Doctor | MT189132 | PA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 4301093983 | MI |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MD-15603 | HI |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 4301093983 | MI |
NPI | 1700076429 |
---|---|
Provider Name | Dr. Ayano Kiyota |
First Address | Ann Arbor, MI 48108 |
Second Address | Livonia, MI 48152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2007 |
Last Update Date | 10/10/2016 |