Provider Demographics
NPI:1477538148
Name:CODY, ERIN ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:ELIZABETH
Last Name:CODY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:CODY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:95 NATURE WAY
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-1242
Mailing Address - Country:US
Mailing Address - Phone:800-207-4919
Mailing Address - Fax:615-309-6536
Practice Address - Street 1:6452 MILLENNIUM
Practice Address - Street 2:SUITE 100
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-7881
Practice Address - Country:US
Practice Address - Phone:800-207-4919
Practice Address - Fax:615-309-6536
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301095692207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine