Organization
JEFFREY H. DECLAIRE M.D., P.C.
Active
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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