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Individual

DR. JACK ANTHONY BLUMBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD/MBA

Contact information

Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
18303 W 13 MILE RD APT G2, SOUTHFIELD, MI 48076-1114
(248) 792-1248

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4351052370
MI

Other

Enumeration date
05/23/2022
Last updated
06/06/2024
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