Individual
JEROME BEKKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
44633 JOY RD STE 100, CANTON, MI 48187-1731
(734) 453-5360
(734) 453-5380
Mailing address
PO BOX 700890, PLYMOUTH, MI 48170-0955
(734) 453-5360
(734) 453-5380
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
JB010278
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114731255
—
MI
01
—
364570412
TAX ID
MI
Enumeration date
04/22/2006
Last updated
02/17/2011
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