Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 4301092032 | MI |
Y | 207PP0204X | Pediatric Emergency Physician | 4301092032 | MI |
NPI | 1750581252 |
---|---|
Provider Name | Dr. Joseph Bernard House |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-4205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2007 |
Last Update Date | 29/05/2012 |