Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 46427 | MI |
NPI | 1326019639 |
---|---|
Provider Name | George Kazzi |
First Address | Pontiac, MI 48341-5023 |
Second Address | Pontiac, MI 48341-5023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 21/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4413760 | (05) | MI |
A80449 | (02) |