Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 4301075934 | MI |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 4301075934 | MI |
NPI | 1285723130 |
---|---|
Provider Name | Karen L Musolf |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Chelsea, MI 48118-1185 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4225869 | (05) | MI |
C87606 | (02) | MI |