Organization
JEFFREY H. DECLAIRE M.D., P.C.
Active
Other names
DeClaire LaMacchia Orthopaedic Institute
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ERNEST LAMACCHIA MD (VICE PRESIDENT)
(248) 650-2400
Entity
Organization
Contact information
Practice address
1135 W UNIVERSITY DR STE 450, ROCHESTER, MI 48307-1871
(248) 650-2400
(248) 650-4596
Mailing address
PO BOX 9042, BELFAST, ME 04915-9042
(248) 650-2400
(248) 650-4596
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F34848
BLUE CROSS BLUE SHIELD
MI
01
—
0H70719
BLUE CROSS BLUE SHIELD (PHYSICAL THERAPY)
MI
05
—
1942387998
—
MI
Enumeration date
11/01/2006
Last updated
03/26/2018
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