Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301100097 | MI |
N | 111NI0900X | Internist | 4301100097 | MI |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 4301100097 | MI |
NPI | 1659557247 |
---|---|
Provider Name | Matthew Christopher Konerman |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2008 |
Last Update Date | 09/03/2020 |