person
Dr. Jerome E Siudara, DO
General Practice Physician in Cheboygan, Michigan
NPI 1598941346

Jerome E Siudara is a General Practice Physician based in Cheboygan, MI. Jerome E Siudara practices in Cheboygan, MI and has the professional credentials of DO. The NPI Number for Jerome E Siudara is 1598941346 and holds a License No. JS005875 (Michigan).

The current practice location address for Jerome E Siudara is 7786 Mullett Lake Rd, Cheboygan, MI and can be reached out via phone at 231-627-2869 and via fax at 231-627-2869.

Location: 7786 Mullett Lake Rd, Cheboygan, MI, 49721-9056
person
Provider Profile Details
NPI Number
1598941346
Provider Name
Jerome E Siudara
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
7786 Mullett Lake Rd, Cheboygan, MI, 49721-9056
Phone Number
231-627-2869
Fax Number
231-627-2869
Provider Enumeration Date
01/10/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1651630495 01 MI BCBSM
111350021 05 MI
institution
Provider Business Practice Location Address Details
Address
7786 Mullett Lake Rd
City
State
Zip
49721-9056
Phone Number
231-627-2869
Fax Number
231-627-2869
person
Provider Business Mailing Address Details
Address
7786 Mullett Lake Rd
City
State
Zip
49721-9056
Phone Number
231-627-2869
Fax Number
231-627-2869
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
Gynecology
Taxonomy
License No.
JS005875 (Michigan)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
JS005875 (Michigan)
Definition
Definition to come...
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