Individual
JAIME RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301059475
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104226795
—
MI
05
—
104264141
—
MI
01
—
35-0-14-4904-2
BCBSM
MI
01
—
700A460030
BCBSM - GROUP
MI
Enumeration date
08/22/2005
Last updated
01/20/2012
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