Individual
DR. JOHN ALEX JANSEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7300 N CANTON CENTER RD, EMERGENCY MEDICINE DEPARTMENT, CANTON, MI 48187-1579
(734) 454-8002
(866) 250-6385
Mailing address
38935 ANN ARBOR RD, CREDENTIALING/PAYOR CONTACTING, LIVONIA, MI 48150-3397
(734) 805-0487
(866) 250-6385
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301045424
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962540419
—
MI
Enumeration date
02/04/2007
Last updated
05/21/2010
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