Individual
JACKLYN L QUADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1051 N CANTON CENTER ROAD, CANTON, MI 48187-5097
(734) 844-5400
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
Primary
4301098317
MI
207RS0010X
Sports Medicine (Internal Medicine) Physician
4301098317
MI
208000000X
Pediatrics Physician
4301098317
MI
Other
Enumeration date
05/25/2011
Last updated
03/06/2020
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