Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 054190 | MI |
NPI | 1538233044 |
---|---|
Provider Name | Leland J. Ropp |
First Address | Dearborn, MI 48126 |
Second Address | Dearborn, MI 48126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A02786 | (02) | |
LR054190 | CHAMPUS-CHAMPUS (01) | |
LR054190 | COMMERCIAL-COMMERCIAL NUMBER (01) |