Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 4301088582 | MI |
NPI | 1285888347 |
---|---|
Provider Name | Dr. Shalom Mazaki-Tovi |
First Address | West Bloomfield, MI 48322-1383 |
Second Address | West Bloomfield, MI 48322-1383 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2008 |
Last Update Date | 15/11/2008 |