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Individual
JEREMY JAMES ACKERMANN
Active
Individual
JEREMY JAMES ACKERMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
976
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009760
—
SC
01
—
080172610
RAILROAD MCARE
—
Enumeration date
06/24/2006
Last updated
05/25/2022
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