Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 038576 | MI |
NPI | 1144274788 |
---|---|
Provider Name | John W Walker |
First Address | Ann Arbor, MI 48105-1598 |
Second Address | Saint Joseph, MI 49085-2112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 05/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3167840 | (05) | MI |
3233820 | (05) | MI |
4541564 | (05) | MI |
4707920 | (05) | MI |
4730721 | (05) | MI |
F28218 | (02) | MI |
JW038576 | BLUE CROSS BLUE SHIELD (01) | MI |