Individual
DR. JAY W EASTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30795 23 MILE RD STE 202, CHESTERFIELD, MI 48047-5721
(586) 421-1740
(586) 421-1744
Mailing address
30795 23 MILE RD STE 202, CHESTERFIELD, MI 48047-5721
(586) 421-1740
(586) 421-1744
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
JE031896
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350F314450
BLUE CROSS AND BLUE SHIEL
MI
05
—
4324769
—
MI
01
—
4332911
AETNA
MI
01
—
P41188
BLUE CARE NETWORK
MI
Enumeration date
08/24/2005
Last updated
06/17/2020
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