Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 4301037103 | MI |
N | 208000000X | Pediatrician | 4301037103 | MI |
NPI | 1235228107 |
---|---|
Provider Name | Georgiana M Sanders |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48105-9484 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 02/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1547312 | (05) | MI |
A78532 | (02) | MI |