Individual
DR. JEFFREY H DECLAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1135 W UNIVERSITY DR, SUITE 450, ROCHESTER, MI 48307-1871
(248) 650-2400
(248) 650-4596
Mailing address
1135 W UNIVERSITY DR, SUITE 450, ROCHESTER, MI 48307-1871
(248) 650-2400
(248) 650-4596
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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