Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | JV400212 | MI |
NPI | 1063536597 |
---|---|
Provider Name | Dr. John Michael Voulgaris |
First Address | Jackson, MI 49203-3605 |
Second Address | Jackson, MI 49203-3605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T33985 | (02) | MI |