Edurese, Jose Tad-Y

Edurese, Jose Tad-Y is an individual health care provider with primary practice located at 205 N East Ave , Jackson MI 49201-1753. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Edurese, Jose Tad-Y can be contacted via phone (517) 788-4800.

Contact Information

Primary practice address
205 N East Ave Jackson MI 49201-1753
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301032704 Michigan

Profile Details

NPI number 1801854344
LBN Legal business name Edurese, Jose Tad-Y
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Jan 15th, 2009 - about 16 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 1801854344 NPPES
Michigan MEDICAID 101591571
Michigan Other 11023493

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