Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 4301086600 | MI |
NPI | 1134339518 |
---|---|
Provider Name | Karen Lynn Plymel |
First Address | Dearborn, MI 48124-1740 |
Second Address | Dearborn, MI 48124-1740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 11/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
KP086600 | LICENSE (01) | MI |