Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 4301096790 | MI |
NPI | 1033434253 |
---|---|
Provider Name | Dr. Elizabeth Bulat |
First Address | West Bloomfield, MI 48322-3013 |
Second Address | West Bloomfield, MI 48322-3013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 11/02/2021 |