Individual
DR. JEFFREY EDWIN MIDDELDORF
Active
Individual
DR. JEFFREY EDWIN MIDDELDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2301003007
MI
208100000X
Physical Medicine & Rehabilitation Physician
2238841
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5101012371
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2555002114BX33
BC/BS
—
05
—
3742088
—
MI
Enumeration date
08/22/2006
Last updated
12/10/2013
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