Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PT0000663 | MI |
N | 222Z00000X | Podiatrist | PT0000663 | MI |
Y | 213E00000X | Podiatrist | PT000663 | MI |
Y | 222Z00000X | Podiatrist | PT000663 | MI |
NPI | 1043375173 |
---|---|
Provider Name | Dr. Paul Ling Tai |
First Address | Taylor, MI 48180-3832 |
Second Address | Taylor, MI 48180-3832 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 20/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1891228 | (05) | MI |
T34282 | (02) | MI |