Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 5101007247 | MI |
NPI | 1093728255 |
---|---|
Provider Name | Dr. Francis A Komara |
First Address | East Lansing, MI 48824-1315 |
Second Address | East Lansing, MI 48824-1313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 03/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4337604 | (05) | MI |
A77971 | (02) | MA |