Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | LD053026 | MI |
NPI | 1104870963 |
---|---|
Provider Name | Dr. Laura J Danz |
First Address | Traverse City, MI 49684-2369 |
Second Address | Traverse City, MI 49684-2369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 24/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F30938 | (02) | MI |