Provider Demographics
NPI:1063536597
Name:VOULGARIS, JOHN MICHAEL (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:VOULGARIS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2797 SPRING ARBOR RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-3605
Mailing Address - Country:US
Mailing Address - Phone:517-784-0900
Mailing Address - Fax:517-784-7835
Practice Address - Street 1:2797 SPRING ARBOR RD
Practice Address - Street 2:SUITE A
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3605
Practice Address - Country:US
Practice Address - Phone:517-784-0900
Practice Address - Fax:517-784-7835
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIJV400212213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT33985Medicare UPIN