Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301081633 | MI |
Y | 2080P0204X | Pediatric Emergency Doctor | 4301081633 | MI |
NPI | 1053432807 |
---|---|
Provider Name | Dr. Marisa Chong Louie |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 03/06/2019 |