Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 20122 | WI |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 4301033245 | MI |
NPI | 1083677439 |
---|---|
Provider Name | Robert J Austin |
First Address | Kalamazoo, MI 49007-5341 |
Second Address | Kalamazoo, MI 49007-5341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 08/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1558407189 | GROUP NPI (01) | MI |
1604114351 | BCBS (01) | MI |
4656419 | (05) | MI |
6062403 | (05) | MI |
A74027 | (02) | MI |