Individual
WALTER JACQUEMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21258 M 68 HWY, ONAWAY, MI 49765-9692
(989) 733-2082
(989) 733-8487
Mailing address
PO BOX 427, HILLMAN, MI 49746-0427
(989) 354-2197
(989) 354-1952
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301044354
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3446696
—
MI
01
—
930074426
RAILROAD MEDICARE
—
01
—
WJ044354
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/19/2005
Last updated
01/30/2017
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