Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 5901000723 | MI |
N | 111NR0200X | Radiology | 5901000723 | MI |
N | 213ER0200X | Radiology | 5901000723 | MI |
N | 2081S0010X | Sports Medicine | 5901000723 | MI |
N | 213ES0000X | Sports Medicine | 5901000723 | MI |
N | 213ES0103X | Foot & Ankle Surgery | 5901000723 | MI |
NPI | 1114912771 |
---|---|
Provider Name | Dr. Louis Bitoff JR. |
First Address | Farmington Hills, MI 48334-3264 |
Second Address | Southfield, MI 48075-4403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 01/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
480F37288 | NEW BARNA BC PIN (01) | MI |
4844437 | (05) | MI |
4856316770 | BLUE CROSS BLUE SHIELD MICHIGAN (01) | MI |
P00322027 | RAILROAD MEDICARE (01) | MI |
T34401 | (02) | MI |