Individual
DR. AUGUSTO M. JAMORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22250 PROVIDENCE DR, SUITE 207, SOUTHFIELD, MI 48075-4825
(248) 552-0360
Mailing address
22250 PROVIDENCE DR, SUITE 207, SOUTHFIELD, MI 48075-4825
(248) 552-0360
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
43-01-033507
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0637767
BLUE CROSS BLUE SHIELD
MI
01
—
43-01-033507
PHYSICIAN STATE LICENSE
MI
Enumeration date
07/25/2006
Last updated
05/06/2008
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