Individual
DR. JEROME SITNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4771 MICHIGAN AVE, DETROIT, MI 48210-3247
(313) 897-2600
(313) 897-2424
Mailing address
4771 MICHIGAN AVE, DETROIT, MI 48210-3247
(313) 897-2600
(313) 897-2424
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
JS005168
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0858218024
BCBS NUMBERS
MI
01
—
0P01030
MEDICARE GROUP NUMBER
MI
05
—
1117984
—
MI
01
—
1164492500
NPI INDIVIDUAL
MI
01
—
1285813154
NPI # GROUP
MI
01
—
381886254
COMMERICAL NUMBERS
MI
01
—
P0103003
MEDICARE INDIVIDUAL #S
MI
Enumeration date
01/26/2006
Last updated
10/29/2007
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