Individual
JOSE MALDONADO-VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 W 6TH ST, CLARE, MI 48617-1409
(989) 386-9951
Mailing address
2000 GREEN RD, SUITE 300, ANN ARBOR, MI 48105-1598
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
069529
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4081929
—
MI
05
—
4081938
—
MI
05
—
4081947
—
MI
05
—
4091934
—
MI
05
—
4091943
—
MI
01
—
JM069529
BC/BS
MI
Enumeration date
06/08/2006
Last updated
08/31/2010
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