Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 5901001739 | MI |
NPI | 1104862796 |
---|---|
Provider Name | Dr. Patricia S. Guisinger |
First Address | Holland, MI 49424-8998 |
Second Address | Holland, MI 49424-8998 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 27/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3516754 | (05) | MI |
3516763 | (05) | MI |
480029237 | RRMEDICARE (01) | MI |
4857010700 | BCBSM (01) | MI |
U37288 | (02) | MI |