Individual
DR. JILL E. KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3901 BEAUBIEN, CHILDREN'S HOSPITAL OF MI, DETROIT, MI 48201
(313) 745-0113
(313) 993-7166
Mailing address
4201 ST. ANTIONE UHC 5D, UNIVERSITY PEDIATRICIANS, DETROIT, MI 48201
(313) 966-5051
(313) 966-0665
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
4301051696
MI
208000000X
Pediatrics Physician
Primary
4301051696
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B51090
BLUE SHIELD
MI
05
—
2787690
—
MI
Enumeration date
10/11/2006
Last updated
10/10/2014
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