Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | 099894 | OH |
Y | 2080P0205X | Pediatric Endocrinologist | MD2017-0244 | NM |
NPI | 1104950708 |
---|---|
Provider Name | Laurie A. Minarich |
First Address | Cleveland, OH 44195-0001 |
Second Address | Albuquerque, NM 87106-2719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 20/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0073958 | (05) | OH |