Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 4301077156 | MI |
NPI | 1023010204 |
---|---|
Provider Name | Waleed H Doghmi |
First Address | Midland, MI 48640-2761 |
Second Address | Midland, MI 48640-2761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 05/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104838725 | (05) | MI |
G85161 | (02) |