Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 5101024389 | MI |
Y | 2081S0010X | Sports Medicine | 5101024389 | MI |
Y | 213ES0000X | Sports Medicine | 5101024389 | MI |
NPI | 1093135410 |
---|---|
Provider Name | Reina Nakamura |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48108-3364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2014 |
Last Update Date | 11/11/2020 |