Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 4301082332 | MI |
NPI | 1083729933 |
---|---|
Provider Name | Joshua M White |
First Address | Lansing, MI 48906 |
Second Address | Lansing, MI 48910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 10/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104897332 | (05) | MI |
I61281 | (02) | MI |