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NPI Code Detail

MEDICARE: DR. KEI MIYAZAKI M.D.

MEDICARE: DR. KEI MIYAZAKI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1790948834
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEI MIYAZAKI M.D.
Provider Business Mailing Address
First Line : 1500 E MEDICAL CENTER DR
Second Line : L2003 WOMEN'S HOSPITAL, SPC 5239
City : ANN ARBOR
State : MI
Zip : 48109-5000
Country : US
Telephone Number : 734-615-2690
Fax Number : 734-615-2687
Provider Business Practice Location Address
First Line : 1500 E MEDICAL CENTER DR
Second Line : L2003 WOMEN'S HOSPITAL, SPC 5239
City : ANN ARBOR
State : MI
Zip : 48109-5000
Country : US
Telephone Number : 734-615-2690
Fax Number : 734-615-2687
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2008
Last Update Date : 07/09/2008

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