Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 262012 | NY |
Y | 207P00000X | Emergency Physician | 4301092920 | MI |
NPI | 1013170315 |
---|---|
Provider Name | Raymond Scurek |
First Address | Chicago, IL 60689-5325 |
Second Address | Grand Rapids, MI 49503-2560 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 10/06/2016 |