Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 48778 | WI |
N | 208600000X | Surgeon | 48778 | WI |
Y | 2086S0120X | Pediatric Surgery | 4301102841 | MI |
NPI | 1386694958 |
---|---|
Provider Name | Emily T Durkin |
First Address | Grand Rapids, MI 49503-2556 |
Second Address | Grand Rapids, MI 49503-2556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 25/06/2013 |