Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 4301030920 | MI |
NPI | 1144214651 |
---|---|
Provider Name | Nicholas C Relich |
First Address | Detroit, MI 48236-2169 |
Second Address | Detroit, MI 48236-2169 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2005 |
Last Update Date | 10/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6055347 | (05) | MI |