Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301054936 | MI |
Y | 2080P0202X | Pediatric Cardiologist | 4301054936 | MI |
NPI | 1285693838 |
---|---|
Provider Name | Nancy Goldman Cutler |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 22/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
350F364260 | BCBSM (01) | MI |
4225537 | (05) | MI |
F46888 | (02) | MI |