Individual
JACKSON JEIKAI LIANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101025144
MI
207R00000X
Internal Medicine Physician
55359
MN
207RC0000X
Cardiovascular Disease Physician
5101025144
MI
207RC0000X
Cardiovascular Disease Physician
5101025144
MN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
5101025144
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
06/09/2011
Last updated
10/19/2020
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