Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1467793836 |
---|---|
Provider Name | Eric Oertel |
First Address | Waterford, MI 48328-2163 |
Second Address | Waterford, MI 48328-2163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2013 |
Last Update Date | 11/03/2013 |