Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 4301112484 | MI |
NPI | 1003343153 |
---|---|
Provider Name | Dr. Meagan Crofoot |
First Address | Saginaw, MI 48602-5303 |
Second Address | Saginaw, MI 48602-5303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2017 |
Last Update Date | 19/05/2017 |