Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4301064289 | MI |
NPI | 1013951508 |
---|---|
Provider Name | Dr. Robert L Highhouse |
First Address | Kalamazoo, MI 49006-4231 |
Second Address | Kalamazoo, MI 49006-4231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 12/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013951508 | (05) | MI |
155658 | GREAT LAKES HLTH PLN (01) | |
2003904442 | BCBS IND PIN (01) | MI |
200C911390 | BCBS GRP PIN (01) | MI |
4425583-10 | (05) | MI |
7707258 | AETNA (01) | |
G94841 | (02) |