Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 5101010947 | MI |
NPI | 1124020276 |
---|---|
Provider Name | Dr. Edward Gerard Loniewski |
First Address | Novi, MI 48377-2982 |
Second Address | Novi, MI 48377-2982 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 12/02/2020 |