Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 4301029951 | MI |
NPI | 1205889060 |
---|---|
Provider Name | Dr. Don A Good |
First Address | Traverse City, MI 49684-2369 |
Second Address | Traverse City, MI 49684-2369 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 29/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A75921 | (02) | MI |