Green, Jae Michael

Green, Jae Michael is an individual health care provider with primary practice located at 601 John St Suite M424, Kalamazoo MI 49007-5341. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Green, Jae Michael can be contacted via phone (269) 349-3350.

Contact Information

Primary practice address
601 John St Suite M424 Kalamazoo MI 49007-5341
Phone: (269) 349-3350
Fax: (269) 349-2403
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 5601005905 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601005905 Michigan

Profile Details

NPI number 1437469731
LBN Legal business name Green, Jae Michael
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2010
Last updated Dec 15th, 2020 - about 5 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 1437469731 NPPES
Michigan Other 5601005905 MICHIGAN STATE LICENSE

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