Individual
JAY IDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
28745 HALLCROFT CT, SOUTHFIELD, MI 48034-2010
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301116870
MI
207VM0101X
Maternal & Fetal Medicine Physician
MD475987
PA
Other
Enumeration date
04/17/2015
Last updated
08/31/2022
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