Individual
DR. JENNY G ATAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4201 SAINT ANTOINE ST, SUITE 3R, DETROIT, MI 48201-2153
(313) 745-3000
Mailing address
29626 JEFFERSON AVE, ST CLAIR SHORES, MI 48082-1827
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301055798
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301055798
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103031619
—
MI
05
—
103031628
—
MI
01
—
JA055798
BC/BS OF MICHIGAN
MI
Enumeration date
05/31/2006
Last updated
06/18/2010
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