Individual
DR. JENNIFER MICHELLE DRISCOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4613 W MAIN ST, SUITE A, KALAMAZOO, MI 49006-2645
(269) 488-8672
(269) 488-8673
Mailing address
4613 W MAIN ST, SUITE A, KALAMAZOO, MI 49006-2645
(269) 488-8672
(269) 488-8673
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301079562
MI
208000000X
Pediatrics Physician
4301079562
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103912432
BCBS IND PIN
—
01
—
110C913020
BCBS GRP PIN
—
01
—
157805
GREAT LAKES HLTH PLN
—
05
—
489567910
—
MI
Enumeration date
06/29/2006
Last updated
12/31/2014
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