Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 4301406723 | MI |
NPI | 1003861055 |
---|---|
Provider Name | Dr. Gail Ann Cookingham |
First Address | Flint, MI 48507-2977 |
Second Address | Kimball, MI 48074 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 09/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E29981 | (02) |