Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4301033966 | MI |
NPI | 1013999713 |
---|---|
Provider Name | John David Denzin |
First Address | Ann Arbor, MI 48106 |
Second Address | Ypsilanti, MI 48197-8634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 12/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101582 | CARE CHOICES (01) | MI |
2008154942 | BLUE CROSS BLUE SHIELD (01) | MI |
4774280 | (05) | MI |
D83147 | (02) | MI |