Middeldorf, Jeffrey Edwin

Middeldorf, Jeffrey Edwin is an individual health care provider with primary practice located at 5700 E 11 Mile Road Suite C, Warren MI 48089. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Middeldorf, Jeffrey Edwin can be contacted via phone (586) 558-4482.

Contact Information

Primary practice address
5700 E 11 Mile Road Suite C Warren MI 48089
Phone: (586) 558-4482
Fax: (586) 558-8923
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 2301003007 Michigan
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 5101012371 Michigan
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 2238841 New York

Profile Details

NPI number 1063528958
LBN Legal business name Middeldorf, Jeffrey Edwin
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2006
Last updated Dec 10th, 2013 - about 13 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 1063528958 NPPES
Michigan MEDICAID 3742088
Michigan Other 2555002114BX33

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