Organization
JAN MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOREN CHUDLER DO (CEO)
(248) 921-5593
Entity
Organization
Contact information
Practice address
45686 S LAKE DR, NOVI, MI 48377-3919
(248) 921-5593
Mailing address
45686 S LAKE DR, NOVI, MI 48377-3919
(248) 921-5593
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101012791
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164477816
—
MI
Enumeration date
08/16/2018
Last updated
06/27/2019
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