Individual
DR. JACQUELYN NICOLE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11012 E 13 MILE RD, STE # 212, WARREN, MI 48093-2572
(586) 582-7150
(586) 582-7164
Mailing address
11012 E 13 MILE RD, STE # 212, WARREN, MI 48093-2572
(586) 582-7150
(586) 582-7164
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301083536
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-0502308-2
BCBSM PIN NUMBER
MI
Enumeration date
05/14/2007
Last updated
01/16/2009
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