Individual
DR. JERRY UZANSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4771 MICHIGAN AVE, DETROIT, MI 48210-3247
(313) 897-2600
(313) 897-2424
Mailing address
4771 MICHIGAN AVE, DETROIT, MI 48210-3247
(313) 897-2600
(313) 897-2424
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
GU005238
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0258220204
BCBS NUMBER
MI
01
—
0P01030
MEDICARE GROUP NUMBER
MI
05
—
1117993
—
MI
01
—
1285813154
NPI GROUP NUMBER
MI
01
—
1477523892
NPI INDIVIDUAL
MI
01
—
P01030002
MEDICARE INDIVIDUAL #S
MI
Enumeration date
01/26/2006
Last updated
10/29/2007
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