Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | MA000522 | MI |
Y | 222Z00000X | Podiatrist | MA000522 | MI |
NPI | 1053381897 |
---|---|
Provider Name | Marvin Aronovitz |
First Address | Trenton, MI 48183-2323 |
Second Address | Sterling Heights, MI 48312-6304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0005627092 | AETNA (01) | MI |
4391135 | (05) | MI |
4795136 | (05) | MI |
T34055 | (02) | MI |