Individual
GRACE YIN JENQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 EARHART RD, ANN ARBOR, MI 48105-2768
(734) 769-0177
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
4301109141
MI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
4301109141
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001397050
—
CT
Enumeration date
07/11/2006
Last updated
03/09/2020
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