Individual
JENNIFER CHRISTINE MAXAM FENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
419 W. WACKERLY ST, MIDLAND, MI 48640
(989) 631-9515
(989) 835-6824
Mailing address
419 W. WACKERLY ST, MIDLAND, MI 48640
(989) 631-9515
(989) 835-6824
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
JG013790
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4287010
—
MI
Enumeration date
03/17/2006
Last updated
07/10/2024
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