Individual
JEFFREY LEE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1535 GULL RD STE 200, KALAMAZOO, MI 49048-1638
(269) 388-6350
(269) 388-6360
Mailing address
1535 GULL RD STE 200, KALAMAZOO, MI 49048-1638
(269) 388-6350
(269) 388-6360
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005572
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417961137
BCBSM
MI
Enumeration date
08/25/2009
Last updated
10/23/2018
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