Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 4301050119 | MI |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 4301050119 | MI |
NPI | 1205873361 |
---|---|
Provider Name | Marjorie C. Treadwell |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-4276 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 14/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F00472 | (02) | MI |