Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 4301404775 | MI |
NPI | 1568564813 |
---|---|
Provider Name | Dr. Maria Jevitz Patterson |
First Address | East Lansing, MI 48824-1315 |
Second Address | Lansing, MI 48912-1897 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 04/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1844326 | (05) | MI |
3117740 | (05) | MI |
B43531 | (02) | MI |