Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0122X | Plastic and Reconstructive Surgery | 4301035365 | MI |
NPI | 1255444907 |
---|---|
Provider Name | Dr. Edward David Lanigan |
First Address | Niles, MI 49120-2203 |
Second Address | Niles, MI 49120-2203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 27/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1255444907 | (05) | MI |
4354697 | (05) | MI |
A74541 | (02) | MI |