Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4301074078 | MI |
NPI | 1003860651 |
---|---|
Provider Name | Mr. Michael R Veale |
First Address | Iron Mountain, MI 49801-3648 |
Second Address | Iron Mountain, MI 49801-3639 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 10/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104758348 | (05) | MI |
2002210652 | BLUE CROSS MICHIGAN (01) | MI |
34670500 | (05) | WI |
982391045173 | PREFERRED ONE (01) | MI |
I39917 | (02) | MI |