Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 016148 | MI |
NPI | 1124090055 |
---|---|
Provider Name | Dr. Robert Michael Rybicki |
First Address | Novi, MI 48375-5604 |
Second Address | Novi, MI 48375-5600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2006 |
Last Update Date | 08/07/2007 |