Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | FM026651 | MI |
NPI | 1033140959 |
---|---|
Provider Name | Frederick Victor Minkow |
First Address | Bloomfield Hills, MI 48302-0561 |
Second Address | Bloomfield Hills, MI 48302-0561 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 06/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2006364692 | BCBS OF MICHIGAN (01) | MI |
4033162 | AETNA (01) | MI |
B46868 | (02) |