Individual
JEFFREY C MAGNATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3601 W FRONT ST, TRAVERSE CITY, MI 49684
(231) 946-1120
(231) 946-8943
Mailing address
3601 W FRONT ST, TRAVERSE CITY, MI 49684-8151
(231) 946-1120
(231) 946-8943
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2015-01478
NC
207Q00000X
Family Medicine Physician
Primary
5101019776
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417216854
—
MI
Enumeration date
05/04/2012
Last updated
09/12/2019
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