Individual
DR. JEFFREY JOHN VAN LAERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-3000
Mailing address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-3000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301103486
MI
207P00000X
Emergency Medicine Physician
D0081295
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2013
Last updated
11/01/2018
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