Medical School Information |
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Medical School Name
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OTHER
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Individual professional's medical school
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Graduation Year
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2006
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Individual professional's medical school graduation year
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Primary Specialty
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NEPHROLOGY
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Primary medical specialty reported by the individual professional in the selected enrollment
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Secondary Specialty 1
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INTERNAL MEDICINE
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First secondary medical specialty reported by the individual professional in the selected enrollment
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Secondary Specialty 2
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UROLOGY
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Second secondary medical specialty reported by the individual professional in the selected enrollment
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All Secondary Specialties
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INTERNAL MEDICINE, UROLOGY
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All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas
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Hospital(s) Affiliation Information |
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Hospital Affiliation CCN 1
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230002
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Medicare CCN of hospital where individual professional provides service 1
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Hospital Affiliation LBN 1
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ST MARY MERCY HOSPITAL
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Legal business name of hospital where individual professional provides service 1
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Hospital Affiliation CCN 2
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230244
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Medicare CCN of hospital where individual professional provides service 2
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Hospital Affiliation LBN 2
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GARDEN CITY HOSPITAL
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Legal business name of hospital where individual professional provides service 2
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Hospital Affiliation CCN 3
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230146
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Medicare CCN of hospital where individual professional provides service 3
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Hospital Affiliation LBN 3
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HENRY FORD WYANDOTTE HOSPITAL
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Legal business name of hospital where individual professional provides service 3
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Hospital Affiliation CCN 4
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230270
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Medicare CCN of hospital where individual professional provides service 4
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Hospital Affiliation LBN 4
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BEAUMONT HOSPITAL - TAYLOR
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Legal business name of hospital where individual professional provides service 4
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Hospital Affiliation CCN 5
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230176
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Medicare CCN of hospital where individual professional provides service 5
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Hospital Affiliation LBN 5
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BEAUMONT HOSPITAL - TRENTON
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Legal business name of hospital where individual professional provides service 5
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Professional Accepts Medicare Assignment
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Y
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