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Individual
MICHAEL L WARREN
Active
Individual
MICHAEL L WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002307
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265525877
—
MI
01
—
382454555014
TRICARE
MI
Enumeration date
10/02/2006
Last updated
01/13/2015
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