Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 4301064214 | MI |
NPI | 1336137264 |
---|---|
Provider Name | Dr. Christopher J Conlin |
First Address | Clarkston, MI 48346-2794 |
Second Address | Flint, MI 48532-3616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2005 |
Last Update Date | 10/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4458440 | (05) | MI |
4458459 | (05) | MI |
4458468 | (05) | MI |
4458477 | (05) | MI |
4458486 | (05) | MI |
4459240 | (05) | MI |
G52164 | (02) | MI |