# JERRY NOSANCHUK DO PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023281706
- **Authorized official:** DR. JERRY NOSANCHUK DO (PHYSICIAN)
- **Authorized official phone:** (248) 926-8080

## Contact information

- **Practice address:** 31500 TELEGRAPH RD, SUITE 210, BINGHAM FARMS, MI 48025-4367
- **Practice address phone:** (248) 644-7200
- **Practice address fax:** (248) 644-7210
- **Mailing address:** 4545 NORTHRIDGE CT, WEST BLOOMFIELD, MI 48323-1397
- **Mailing address phone:** (248) 926-8080
- **Mailing address fax:** (248) 926-8077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/02/2008
- **Last updated:** 01/26/2026