Individual
JENNIFER HOUTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4613 W MAIN ST, SUITE A, KALAMAZOO, MI 49006-2645
(269) 488-8672
(269) 488-8673
Mailing address
4613 W MAIN ST, STE A, KALAMAZOO, MI 49006-2698
(269) 349-2641
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
JH075631
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-31681
PHP PROV #
—
01
—
2334854
UNITED HEALTHCARE
—
01
—
23904
HEALTH PLAN OF MI
MI
05
—
5218152
—
MI
01
—
CA1068
RAILROAD MEDICARE
MI
01
—
JH075631
STATE LICENSE #
MI
01
—
P25914F
BLUE CARE NETWORK
MI
Enumeration date
11/04/2005
Last updated
06/08/2016
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