Jackson, M David

Jackson, M David is an individual health care provider with primary practice located at 28455 Haggerty Rd Suite 200, Novi MI 48377-2982. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Jackson, M David can be contacted via phone (248) 893-3200.

Contact Information

Primary practice address
28455 Haggerty Rd Suite 200 Novi MI 48377-2982
Phone: (248) 893-3200
Fax: (248) 893-2950
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 4301048803 Michigan

Profile Details

NPI number 1730177296
LBN Legal business name Jackson, M David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Jul 10th, 2023 - about last year

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 1730177296 NPPES
Michigan MEDICAID 3228178

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