Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 4301088355 | MI |
NPI | 1083815559 |
---|---|
Provider Name | Mrs. Melissa Linnae Somers |
First Address | Petoskey, MI 49770-2277 |
Second Address | Petoskey, MI 49770-2277 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 26/08/2013 |