Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 4301058595 | MI |
NPI | 1033160502 |
---|---|
Provider Name | Dr. Julie Ann Dodds |
First Address | East Lansing, MI 48823-5384 |
Second Address | East Lansing, MI 48823-5384 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 22/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0M21440043 | MEDICARE PLUS BLUE (01) | MI |
1016065 | MCLAREN HEALTH ADVANTAGE (01) | MI |
1016065 | MCLAREN HEALTH PLAN-COMMERCIAL (01) | MI |
1016065 | MCLAREN HEALTH PLAN-MEDICAID (01) | MI |
200000001893 | PHP (01) | MI |
200000001893 | PHP FAMILYCARE (01) | MI |
2003302131 | BCBS/BCN (01) | MI |
4224321 | AETNA (01) | MI |
4764980 | (05) | MI |
B84807 | (02) | MI |