Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301078541 | MI |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 4301078541 | MI |
NPI | 1023032398 |
---|---|
Provider Name | Karl C Desch |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-4254 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4789809 | (05) | MI |
I44783 | (02) |