Organization
JERRY NOSANCHUK DO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY NOSANCHUK DO (PHYSICIAN)
(248) 926-8080
Entity
Organization
Contact information
Practice address
31500 TELEGRAPH RD, SUITE 210, BINGHAM FARMS, MI 48025-4367
(248) 644-7200
(248) 644-7210
Mailing address
4545 NORTHRIDGE CT, WEST BLOOMFIELD, MI 48323-1397
(248) 926-8080
(248) 926-8077
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0158224424
BCBS MICHIGAN
MI
Enumeration date
04/02/2008
Last updated
01/26/2026
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