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Individual
MRS. AN S ELOWE
Active
Individual
MRS. AN S ELOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
53049
CA
363A00000X
Physician Assistant
MA053026
PA
363AM0700X
Medical Physician Assistant
5601005427
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232664784
GROUP TAX ID
PA
Enumeration date
12/14/2007
Last updated
12/15/2015
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