Doctor Name: | MRS. BAN MECHAEL |
NPI Number: | 1124095666 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | BM073200 |
Business Practice Address: | 19930 Farmington Rd Suite A Livonia, MI - 481521433 |
Business Phone Number: | 2484766209 |
Business Fax Number: | 2484766237 |
Mailing Address: | 19930 Farmington Rd, Suite A LIVONIA |
State: | MI |
Postal Code: | 48152 |
Phone Number: | 2484766209 |
Fax Number: | 2484766237 |
NPI Enumeration Date: | 03/03/2006 |
NPI Last Update Date: | 07/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | BM073200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |