Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 4301098176 | MI |
NPI | 1033311253 |
---|---|
Provider Name | Theron Leroy Dobson |
First Address | Ann Arbor, MI 48105-9484 |
Second Address | Ypsilanti, MI 48197-1014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 04/04/2014 |