Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | JA050190 | MI |
NPI | 1013967819 |
---|---|
Provider Name | Dr. John W Armstead |
First Address | Wayne, MI 48184-1869 |
Second Address | Wayne, MI 48184-1869 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 23/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2654999 | (05) | MI |
B45009 | (02) | MI |