Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 009110 | MI |
Y | 208600000X | Surgeon | 009110 | MI |
NPI | 1003013657 |
---|---|
Provider Name | Dr. Richard C Spinale |
First Address | Garden City, MI 48135-2577 |
Second Address | Garden City, MI 48135-2577 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2842362 | (05) | MI |
E38094 | (02) | MI |