Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 4301088651 | MI |
NPI | 1124243431 |
---|---|
Provider Name | Siddhesh Ramesh Lotlikar |
First Address | Marquette, MI 49855 |
Second Address | Marquette, MI 49855 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 08/07/2007 |