Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 5101008177 | MI |
NPI | 1033189576 |
---|---|
Provider Name | Paul J Drouillard |
First Address | Garden City, MI 48135-2577 |
Second Address | Garden City, MI 48135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 12/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2752040 | (05) | MI |
5823029 | BCBSM (01) | MI |
E49718 | (02) | MI |