Individual
DR. JACLYN MILOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
18100 OAKWOOD BLVD STE 315, DEARBORN, MI 48124-4085
(313) 271-0066
(313) 271-1047
Mailing address
20952 E 12 MILE RD STE 200, SAINT CLAIR SHORES, MI 48081-3203
(586) 771-4820
(586) 771-6620
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301117138
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E06273
BCBSM
MI
01
—
CB9133
RAILROAD MEDICARE
—
Enumeration date
06/26/2009
Last updated
08/14/2019
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