Individual
DR. JEFFREY LEE MICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
3790 117TH LN NW, COON RAPIDS, MN 55433-2666
(763) 421-7300
(763) 421-3337
Mailing address
3790 117TH LN NW, COON RAPIDS, MN 55433-2666
(763) 421-7300
(763) 421-3337
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
620
MN
213ES0103X
Foot & Ankle Surgery Podiatrist
620
MN
213ES0131X
Foot Surgery Podiatrist
620
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140086
UCARE
MN
01
—
2700167
MEDICA
MN
01
—
27D36MI
BLUE CROSS BLUE SHIELD
MN
01
—
33942
HEALTH PARTNERS
MN
05
—
867912600
—
MN
Enumeration date
08/09/2005
Last updated
03/17/2018
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