Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 4301050438 | MI |
NPI | 1003824467 |
---|---|
Provider Name | Dr. James Robert Neuenschwander |
First Address | Ann Arbor, MI 48104-5128 |
Second Address | Ann Arbor, MI 48104-5128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 04/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B48421 | (02) | MI |