Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 15327 | MI |
NPI | 1013033935 |
---|---|
Provider Name | Dr. Gregory Allan Hummon |
First Address | Birmingham, MI 48009-6658 |
Second Address | Birmingham, MI 48009-6658 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 08/07/2007 |