Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 2015015334 | MO |
Y | 2080P0201X | Pediatric Allergist | 4301098327 | MI |
NPI | 1285920744 |
---|---|
Provider Name | Dr. Roua Azmeh |
First Address | Kalamazoo, MI 49008-1282 |
Second Address | Kalamazoo, MI 49008-1282 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2011 |
Last Update Date | 28/09/2017 |