Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 4301089723 | MI |
NPI | 1841401338 |
---|---|
Provider Name | Karen Michelle Bovid |
First Address | Kalamazoo, MI 49008-1282 |
Second Address | Kalamazoo, MI 49008-8054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 04/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1841401338 | (05) | MI |