Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 4301069546 | MI |
NPI | 1053371286 |
---|---|
Provider Name | Paul Alan Berkowitz |
First Address | Ypsilanti, MI 48197-1099 |
Second Address | Ypsilanti, MI 48197-1099 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 21/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4147038-10 | (05) | MI |
E37014 | (02) | MI |