Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 4301063275 | MI |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 43010363275 | MI |
NPI | 1952305765 |
---|---|
Provider Name | Robert Gerald Dodds |
First Address | Farmington Hills, MI 48334-3275 |
Second Address | Farmington Hills, MI 48334-3275 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 26/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
345712510 | (05) | MI |
G68807 | (02) | MI |