Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 00783 | MI |
Y | 222Z00000X | Podiatrist | 00783 | MI |
NPI | 1053383398 |
---|---|
Provider Name | Dr. Geoffrey Earl Clapp |
First Address | Kalamazoo, MI 49001-5600 |
Second Address | Kalamazoo, MI 49001-5600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 26/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0432570002 | DME (01) | MI |
1399775 | (05) | MI |
480C97640 | BLUE CROSS BLUE SHIELD (01) | MI |
5395595 | BLUE CROSS BLUE SHIELD MI (01) | MI |
T33997 | (02) | MI |