Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 4301029560 | MI |
NPI | 1063459055 |
---|---|
Provider Name | Michael Garcia |
First Address | West Bloomfield, MI 48322-3405 |
Second Address | West Bloomfield, MI 48322-3405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 11/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B47338 | (02) | MI |