Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 4301049989 | MI |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 4301049989 | MI |
NPI | 1902883218 |
---|---|
Provider Name | Dr. Richard L Arden |
First Address | Sterling Heights, MI 48314 |
Second Address | Sterling Heights, MI 48314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2005 |
Last Update Date | 09/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040E061920 | BLUE SHIELD MICHIGAN (01) | MI |
104103187 | (05) | MI |
4103187 | (05) | MI |
E08479 | (02) |