Basic Information
| Provider Information | |||||||||
| NPI: | 1447515101 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOWARD | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | DUSTIN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2704 SEMLOH ST | ||||||||
| Address2: | |||||||||
| City: | LAKE ORION | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484253278 | ||||||||
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| Practice Location | |||||||||
| Address1: | 50 N PERRY ST | ||||||||
| Address2: | |||||||||
| City: | PONTIAC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483385000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2012 | ||||||||
| LastUpdateDate: | 07/09/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 5101019854 | MI | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.