Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 4301084398 | MI |
NPI | 1295807113 |
---|---|
Provider Name | Melvin Gordon Mcinnis |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-2700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 19/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4722686 | (05) | MI |
F68677 | (02) | MI |