Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 4301070543 | MI |
Y | 207PE0004X | Emergency Medical Services | 4301070543 | MI |
NPI | 1134189426 |
---|---|
Provider Name | Dr. Matthew J Compton |
First Address | Detroit, MI 48201 |
Second Address | Commerce Township, MI 48382-2201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 13/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104197675 | (05) | MI |
104197684 | (05) | MI |
H22297 | (02) | MI |
MC070543 | BC/BS OF MI (01) | MI |