Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 5101005364 | MI |
N | 2086X0206X | Surgical Oncologist | EL005364 | MI |
NPI | 1326081266 |
---|---|
Provider Name | Dr. Edward Michael Lodish |
First Address | Southfield, MI 48075-6501 |
Second Address | Southfield, MI 48075-6501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 25/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000003077 | CAPE HEALTH PLAN (01) | MI |
020025657 | RAILROAD MEDICARE (01) | MI |
0255011674 | BCBSM (01) | MI |
107509 | CARECHOICES/PREFERREDCHOI (01) | MI |
118395 | GREATLAKEHEALTHPLAN (01) | MI |
1533202 | UNITED MINEWORKERS (01) | MI |
1899208 | (05) | MI |
3689470001 | CIGNA (01) | MI |
4110309 | AETNA PPO (01) | MI |
49119 | OMNICARE COVENTRY (01) | MI |
E37392 | (02) | MI |
E37392 | HAP (01) | MI |
M004233 | TRICARE (01) | MI |