Individual
JEGAN JABEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1686 COLFAX AVE, BENTON HARBOR, MI 49022-7355
(269) 925-8842
(269) 925-8847
Mailing address
8734 VALLEY VIEW DR, BERRIEN SPRINGS, MI 49103-1617
(269) 473-2797
(269) 925-8847
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301064652
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1101111252
BC/BS
MI
05
—
415194310
—
MI
01
—
4301064652
MEDICAL LICENSE NUMBER
MI
Enumeration date
10/18/2006
Last updated
10/18/2007
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