Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 4301049077 | MI |
NPI | 1891715991 |
---|---|
Provider Name | Phillips H Winter |
First Address | Holland, MI 49423 |
Second Address | Holland, MI 49423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2907574 | (05) | MI |
E49680 | (02) | MI |
OG06056 | BCBS (01) | MI |