Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 2901017401 | MI |
N | 204E00000X | Oral & Maxillofacial Surgeon | 2901017401 | MI |
NPI | 1295800506 |
---|---|
Provider Name | Dr. Johnathan T Howard |
First Address | Saginaw, MI 48603-1249 |
Second Address | Saginaw, MI 48603-1249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0994258 | HEALTH PLUS (01) | MI |
0G36100 | BCBS (01) | MI |
U19368 | (02) |