Provider Demographics
NPI:1104067982
Name:MCGHEE, JEWELL LEZELL
Entity type:Individual
Prefix:MS
First Name:JEWELL
Middle Name:LEZELL
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 510851
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48151-6851
Mailing Address - Country:US
Mailing Address - Phone:313-401-2713
Mailing Address - Fax:
Practice Address - Street 1:9630 VIRGIL
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-1416
Practice Address - Country:US
Practice Address - Phone:313-401-2713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No175L00000XOther Service ProvidersHomeopath