Individual
DR. MICHAEL JEREMY JUBANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 N. ACADEMY AVE, DANVILLE, PA 17822-0462
(570) 271-6301
Mailing address
23 3RD ST, DANVILLE, PA 17821-1156
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
BP1-0028963
TX
2085R0202X
Diagnostic Radiology Physician
Primary
MD441379
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4651659625
MYUTMB 4651659625
—
Enumeration date
08/05/2007
Last updated
10/21/2010
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