Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 5101010343 | MI |
NPI | 1134276710 |
---|---|
Provider Name | Yehudah Jay Sandweiss |
First Address | Ann Arbor, MI 48104-2301 |
Second Address | Ann Arbor, MI 48104-2301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F10088 | (02) | MI |