Individual
JEANETTE ALLEN UNDERHILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1620 MEDICAL LN STE 100, FORT MYERS, FL 33907-1143
(239) 275-1164
(239) 275-5212
Mailing address
P.O. BOX 1468, NOVI, MI 48099-1468
(248) 746-0342
(248) 746-0308
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301067713
MI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME130505
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
447790010
—
MI
Enumeration date
08/09/2005
Last updated
07/21/2022
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