Individual
DR. OGENETEGA JEREMIAH MADEDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 E MICHIGAN AVE STE 370, LANSING, MI 48912-1897
(517) 364-5300
(517) 364-5325
Mailing address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 364-5020
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
210011819
DC
207R00000X
Internal Medicine Physician
4301514004
MI
207RI0200X
Infectious Disease Physician
210011819
DC
207RI0200X
Infectious Disease Physician
Primary
4301514004
MI
Other
Enumeration date
04/04/2020
Last updated
07/13/2025
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