Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35128153 | OH |
N | 208000000X | Pediatrician | 4301114213 | MI |
N | 208000000X | Pediatrician | 56541 | CT |
Y | 2080P0204X | Pediatric Emergency Doctor | 4301114213 | MI |
NPI | 1003259250 |
---|---|
Provider Name | Karolina Maksimowski |
First Address | Detroit, MI 48201-2153 |
Second Address | Detroit, MI 48201-2119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2013 |
Last Update Date | 14/08/2018 |