Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 4301046804 | MI |
N | 207V00000X | Obstetrician & Gynecologist | 4301046804 | MI |
NPI | 1073680443 |
---|---|
Provider Name | Mary Helen Quigg |
First Address | Detroit, MI 48202 |
Second Address | Detroit, MI 48202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F13734 | (02) | |
MQ046804 | CHAMPUS-CHAMPUS (01) | |
MQ046804 | COMMERCIAL-COMMERCIAL NUMBER (01) |