Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 4301049953 | MI |
NPI | 1265524292 |
---|---|
Provider Name | Richard K Brown |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 11/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4614642 | (05) | MI |
E41238 | (02) | MI |