Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 30019438 | OH |
NPI | 1396884805 |
---|---|
Provider Name | Dr. Gregory C Michaels |
First Address | Lancaster, OH 43130-2549 |
Second Address | Lancaster, OH 43130-2549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 08/07/2007 |