Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 4301044507 | MI |
NPI | 1285699587 |
---|---|
Provider Name | Mark Falahee |
First Address | Ypsilanti, MI 48197-8634 |
Second Address | Ypsilanti, MI 48197-8634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 13/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A76678 | (02) | MI |