Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 5101012614 | MI |
NPI | 1477551539 |
---|---|
Provider Name | Lynn Elizabeth Beals |
First Address | Ann Arbor, MI 48103-9184 |
Second Address | Ann Arbor, MI 48103-9184 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 31/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1258111844 | BCBS MICH (01) | MI |