Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 5101006075 | MI |
NPI | 1134335359 |
---|---|
Provider Name | Dr. Jerry Avrum Appel |
First Address | Bloomfield Township, MI 48304-1135 |
Second Address | Bloomfield Township, MI 48304-1135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2820150 | (05) | MI |
E51074 | (02) |