Individual
JASON ROBERT FOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-1553
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-1553
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301093002
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301093002
STATE OF MICHIGAN
MI
Enumeration date
09/29/2008
Last updated
02/13/2009
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