Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 24012 | OK |
N | 207V00000X | Obstetrician & Gynecologist | 4301505405 | MI |
Y | 207VX0201X | Gynecologic Oncologist | 4301505405 | MI |
NPI | 1548308448 |
---|---|
Provider Name | Katherine Marie Moxley |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 13/09/2021 |