Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 162597 | NY |
N | 207VE0102X | Reproductive Endocrinologist | 25MA04602200 | NJ |
NPI | 1255478624 |
---|---|
Provider Name | Dr. Michael Charles Darder |
First Address | Kamas, UT 84036-5031 |
Second Address | Kamas, UT 84036-5031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 02/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D91529 | (02) | NJ |