Individual
JEREMY JAMES POLICHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3535 W 13 MILE RD STE 742, ROYAL OAK, MI 48073-6770
(248) 551-9100
Mailing address
885 TIVERTON DRIVE, LOS ANGELES, CA 90095-0001
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4351052366
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4351052366
STATE OF MICHIGAN - DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
MI
Enumeration date
03/03/2023
Last updated
06/13/2024
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