Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 2007-00034 | NC |
N | 207U00000X | Nuclear Medicine Specialist | 7359 | SD |
NPI | 1427194828 |
---|---|
Provider Name | Dr. John E Dahlin |
First Address | Marquette, MI 49855 |
Second Address | Marquette, MI 49855-2711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 02/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3205211281 | BCBS OF MICHIGAN (01) | MI |