Individual
MISHUN DELIESE CHILDS-LOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
1900 COLUMBUS AVE, BAY CITY, MI 48708-6880
(989) 984-3077
(989) 894-6138
Mailing address
PO BOX 660857, DALLAS, TX 75266-0857
(855) 709-4498
(302) 733-0854
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35.081724
OH
207L00000X
Anesthesiology Physician
Primary
4301060250
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0500910292
BCBS
MI
Enumeration date
07/27/2006
Last updated
01/07/2014
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