Individual
DR. JESUS HERNANDEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
104 W 6TH ST, CLARE, MI 48617-1409
(989) 386-9951
Mailing address
2000 GREEN RD, SUITE 300, ANN ARBOR, MI 48105-1598
(734) 995-3764
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
048887
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102865106
—
MI
05
—
104081910
—
MI
01
—
JH048887
BLUE SHIELD
MI
Enumeration date
06/14/2006
Last updated
05/11/2011
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