Individual
IVAN NATHANIEL CO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301106009
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
4301106009
MI
Other
Enumeration date
03/28/2011
Last updated
01/27/2020
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