Maxam Fenner, Jennifer Christine

Maxam Fenner, Jennifer Christine is an individual health care provider with primary practice located at 419 W. Wackerly St , Midland MI 48640. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Maxam Fenner, Jennifer Christine can be contacted via phone (989) 631-9515.

Contact Information

Primary practice address
419 W. Wackerly St Midland MI 48640
Phone: (989) 631-9515
Fax: (989) 835-6824
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X JG013790 Michigan

Profile Details

NPI number 1679542922
LBN Legal business name Maxam Fenner, Jennifer Christine
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Jul 10th, 2024 - 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 1679542922 NPPES
Michigan MEDICAID 4287010

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