Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 4301504010 | MI |
NPI | 1174985345 |
---|---|
Provider Name | Joseph Donovan Dixon |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-2700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2016 |
Last Update Date | 21/06/2021 |