Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 4301045225 | MI |
NPI | 1033127626 |
---|---|
Provider Name | Dr. Renuka Gera |
First Address | East Lansing, MI 48824-1317 |
Second Address | Lansing, MI 48912-1800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 07/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1589303 | (05) | MI |
A79820 | (02) | MI |