Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301034450 | MI |
N | 111NI0900X | Internist | 4301034450 | MI |
Y | 207SG0201X | Clinical Genetics (M.D.) | 4301034450 | MI |
NPI | 1518048057 |
---|---|
Provider Name | Thomas D Gelehrter |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 09/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1243531 | (05) | MI |
B48016 | (02) | MI |