Individual
JERI KEDZIERSKI
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
990 W ANN ARBOR TRL, PLYMOUTH, MI 48170-6204
(734) 414-1099
(734) 414-1065
Mailing address
990 W ANN ARBOR TRL, PLYMOUTH, MI 48170-6204
(734) 414-1099
(734) 414-1065
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301066828
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301066828
LICENSE
MI
Enumeration date
05/20/2006
Last updated
07/08/2007
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