Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 4301069459 | MI |
NPI | 1114904349 |
---|---|
Provider Name | Dr. Girish Juneja |
First Address | Big Rapids, MI 49307-2365 |
Second Address | Big Rapids, MI 49307-2365 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 30/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3461754 | (05) | MI |
4603498 | (05) | MI |
G56091 | (02) | MI |