Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | ND407280 | MI |
NPI | 1144257072 |
---|---|
Provider Name | Neelam Dutt |
First Address | Flint, MI 48532-2700 |
Second Address | Flint, MI 48532-2700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4289383 | (05) | MI |
E49443 | (02) | MI |