Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 5101016371 | MI |
N | 207VX0000X | Obstetrician | 5101016371 | MI |
NPI | 1184808651 |
---|---|
Provider Name | Dr. Eryn Jennifer Hart Dutta |
First Address | Grand Rapids, MI 49503-2560 |
Second Address | Grand Rapids, MI 49503-2572 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2007 |
Last Update Date | 28/12/2021 |