Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 4301059869 | MI |
NPI | 1184662520 |
---|---|
Provider Name | Dr. Beverly Huszarik |
First Address | Oakland Township, MI 48306-2258 |
Second Address | Rochester, MI 48307-1863 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 24/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104275430 | (05) | MI |
BH059869 | BC/BS (01) | MI |
G13409 | (02) | MI |