Individual
PAUL S JERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 PINE GROVE AVE, MCLAREN PORT HURON - EMERGENCY MEDICINE DEPARTMENT, PORT HURON, MI 48060-3511
(810) 989-3300
(810) 985-2671
Mailing address
1221 PINE GROVE AVE, MCLAREN PORT HURON - EMERGENCY MEDICINE DEPARTMENT, PORT HURON, MI 48060-3511
(810) 989-3300
(810) 985-2671
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301055524
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942276084
—
MI
Enumeration date
02/28/2006
Last updated
09/04/2014
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