Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | 6301005259 | MI |
NPI | 1598851883 |
---|---|
Provider Name | Dr. Norman Paul Dwaihy |
First Address | Grosse Pointe Woods, MI 48236 |
Second Address | St Clair Shores, MI 48080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OEO14520 | BCBSM (01) |