Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301041810 | MI |
Y | 2080P0203X | Pediatric Critical Care Doctor | 4301041810 | MI |
NPI | 1093721276 |
---|---|
Provider Name | Frank W Moler |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-4280 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 17/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1783964 | (05) | MI |
B48770 | (02) |