Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 271360 | MA |
Y | 207WX0107X | Retina Specialist | 4301503908 | MI |
NPI | 1003348905 |
---|---|
Provider Name | Tedi Begaj |
First Address | Novi, MI 48375-5392 |
Second Address | Royal Oak, MI 48073-6710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2017 |
Last Update Date | 26/01/2022 |