Individual
DR. JEFF Y THE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
990 W ANN ARBOR TRL, SUITE 202, PLYMOUTH, MI 48170-6204
(734) 455-8497
(734) 455-7907
Mailing address
990 W ANN ARBOR TRL, SUITE 202, PLYMOUTH, MI 48170-6204
(734) 455-8497
(734) 455-7907
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
JT011068
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103654
CARE CHOICES/PREFERRED CH
MI
01
—
1158207454
BCBS
MI
05
—
4530838
—
MI
Enumeration date
04/07/2006
Last updated
07/08/2007
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