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Individual

LARRY LAYTON HUBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

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
367500000X
Certified Registered Nurse Anesthetist
Primary
4704205153
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4806712
MI
01
LH205153
BLUE SHIELD
MI
Enumeration date
03/01/2006
Last updated
11/15/2019
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