Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101006332 | MI |
NPI | 1124007539 |
---|---|
Provider Name | Dr. Ted H Schwartzenfeld |
First Address | Madison Heights, MI 48071-5711 |
Second Address | Madison Heights, MI 48071-5711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2006 |
Last Update Date | 21/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4170644 | (05) | MI |
4170653 | (05) | MI |
4170662 | (05) | MI |
4343620 | (05) | MI |
B44136 | (02) | MI |