Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 2012-01012 | NC |
Y | 2084N0400X | Neurologist | 4301108886 | MI |
NPI | 1043410384 |
---|---|
Provider Name | Martinson Arnan |
First Address | Kalamazoo, MI 49007-5341 |
Second Address | Kalamazoo, MI 49007-5341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2007 |
Last Update Date | 14/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5922239 | (05) | NC |