Individual
DANIEL GERARD JUDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
31 N SAINT JOSEPH AVE, NILES, MI 49120-2207
(269) 687-1448
Mailing address
11869 RANGE LINE RD, BERRIEN SPRINGS, MI 49103-9205
(269) 471-7537
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301052510
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050046347
CHAMPS
MI
05
—
102025370
—
MI
01
—
DJ052510
BCBSMI
MI
Enumeration date
09/01/2006
Last updated
06/13/2014
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