Jagger, Michael

Jagger, Michael is an individual health care provider with primary practice located at 611 E Douglas Suite 309, Mishawaka IN 46545-1467. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Jagger, Michael can be contacted via phone (574) 252-2640.

Contact Information

Primary practice address
611 E Douglas Suite 309 Mishawaka IN 46545-1467
Phone: (574) 252-2640
Fax: (574) 252-2650
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01023464 Indiana

Profile Details

NPI number 1669411807
LBN Legal business name Jagger, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Dec 2nd, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669411807 NPPES
Indiana Other 000000269222 BCBS
Indiana MEDICAID 100222270A BCBS

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