Dr. Jonathon P State, M.D.
Family Medicine in Birmingham, MI. Individual provider (NPI-1).
NPI number1376595066
StatusActive
Last updated in NPPESMay 6, 2011
Details
- NPI
- 1376595066
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jonathon P State
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 17, 2006
- Last updated
- May 6, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 4301074553 | MI | Yes |
Practice location
757 VinewoodBirmingham, MI 48009
Phone 248-644-6029 · Fax 519-258-7896
Mailing address
757 VinewoodBirmingham, MI 48009
Phone 248-644-6029 · Fax 519-258-7896
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