Individual
JOHN WESLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085
(269) 982-4941
Mailing address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 982-4941
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301510522
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2021
Last updated
11/13/2023
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