Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 34-006596 | OH |
NPI | 1083655088 |
---|---|
Provider Name | Michael Kunstmann |
First Address | Cleveland, OH 44193-0005 |
Second Address | Columbus, OH 43213-1546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 05/12/2007 |