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Individual

M DAVID JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
28455 HAGGERTY RD, SUITE 200, NOVI, MI 48377-2982
(248) 893-3200
(248) 893-2950
Mailing address
28455 HAGGERTY RD STE 200, NOVI, MI 48377-2982
(248) 893-3200
(248) 893-2950

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301048803
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3228178
MI
Enumeration date
10/10/2005
Last updated
07/10/2023
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