Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 4704167824 | MI |
NPI | 1033238852 |
---|---|
Provider Name | Julia Ludwig |
First Address | Bangor, MI 49013 |
Second Address | Holland, MI 49424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 08/07/2007 |