Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 4351046304 | MI |
NPI | 1003437294 |
---|---|
Provider Name | Dr. Fiel Ybanez Cunningham |
First Address | Lansing, MI 48912-1811 |
Second Address | Lansing, MI 48912-1811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2020 |
Last Update Date | 29/04/2020 |