Individual
DR. JYOTHSNA I HEREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(248) 344-2490
Mailing address
39450 W 12 MILE RD, NOVI, MI 48377-3600
(248) 344-2490
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036118268
IL
207R00000X
Internal Medicine Physician
4301097123
MI
207RN0300X
Nephrology Physician
Primary
4301097123
MI
Other
Enumeration date
06/11/2007
Last updated
10/11/2017
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