Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2301005440 | MI |
N | 111NI0900X | Internist | 2301005440 | MI |
Y | 111NN0400X | Neurology | 2301005440 | MI |
N | 111NN1001X | Nutrition | 23201005440 | MI |
NPI | 1386871986 |
---|---|
Provider Name | Dr. Brian Alan Sanborn |
First Address | Mount Pleasant, MI 48858-7991 |
Second Address | Mount Pleasant, MI 48858-7991 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2009 |
Last Update Date | 22/06/2009 |