Beaudoin, Jeffrey Blair

Beaudoin, Jeffrey Blair is an individual health care provider with primary practice located at 521 Monroe St , Petoskey MI 49770-2266. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Beaudoin, Jeffrey Blair can be contacted via phone (231) 487-1900.

Contact Information

Primary practice address
521 Monroe St Petoskey MI 49770-2266
Phone: (231) 487-1900
Fax: (231) 348-0984
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 4301057924 Michigan

Profile Details

NPI number 1508821000
LBN Legal business name Beaudoin, Jeffrey Blair
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Nov 19th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508821000 NPPES
Michigan Other 020B41012 BCBS MI
Michigan Other 0B41012 BCBS MI
Michigan Other 020043565 BCBS MI
Michigan MEDICAID 4084724 BCBS MI

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