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Individual

WILLIAM JOSEPH JEAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1414 W FAIR AVE, SUITE 334, MARQUETTE, MI 49855-2675
(906) 225-3870
(906) 225-4861
Mailing address
1414 W FAIR AVE, SUITE 334, MARQUETTE, MI 49855-2675
(906) 225-3870
(906) 225-4861

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301047995
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060021690
RAILROAD MEDICARE
01
0605210701
BLUE CROSS BLUE SHIELD
MI
05
2933618
MI
05
30734300
WI
Enumeration date
06/17/2006
Last updated
02/05/2008
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