Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 4301028014 | MI |
NPI | 1326045907 |
---|---|
Provider Name | Steven William Paris |
First Address | Livonia, MI 48154-5085 |
Second Address | Livonia, MI 48154-5085 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 28/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0308235361 | BC PIN (01) | MI |
A77422 | (02) |