Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 4301071097 | MI |
NPI | 1093885394 |
---|---|
Provider Name | Dr. Pinhas Geva |
First Address | Lansing, MI 48901-3008 |
Second Address | Lansing, MI 48912-1800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3503304381 | BCBS INDIVIDUAL PIN (01) | MI |
4118635 | (05) | MI |
E83947 | (02) | MI |