Individual
DR. JEFFREY H DECLAIRE
Active
Individual
DR. JEFFREY H DECLAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
4301045096
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0632203
BLUE CROSS BLUE SHIELD
MI
05
—
1265442446
—
MI
Enumeration date
08/09/2006
Last updated
06/16/2018
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