Individual
DR. MICHAEL JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 STONE GATE CT, SETAUKET, NY 11733-1346
(631) 974-5018
Mailing address
2 STONE GATE CT, SETAUKET, NY 11733-1346
(631) 974-5018
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
Primary
125543-1
NY
Other
Enumeration date
02/19/2014
Last updated
12/05/2014
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