Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4351048326 | MI |
NPI | 1013542489 |
---|---|
Provider Name | Dr. Michael Gaudiani II |
First Address | Detroit, MI 48202-2608 |
Second Address | Detroit, MI 48202-2689 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2020 |
Last Update Date | 04/11/2021 |