Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 28742020 | WI |
N | 207RH0000X | Hematologist | 4301077211 | MI |
NPI | 1043339138 |
---|---|
Provider Name | Dr. M Elizabeth Atkinson |
First Address | Grand Rapids, MI 49503-1304 |
Second Address | Grand Rapids, MI 49503-1304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31475800 | (05) | WI |
D86988 | (02) |