Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 4301039322 | MI |
NPI | 1265694400 |
---|---|
Provider Name | Dr. Luis Horacio Toledo |
First Address | Portage, MI 49024-5545 |
Second Address | Kalamazoo, MI 49008-1282 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2008 |
Last Update Date | 30/06/2008 |