Provider Demographics
NPI:1124115332
Name:HAROLD I JURAN MD PC
Entity type:Organization
Organization Name:HAROLD I JURAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:I
Authorized Official - Last Name:JURAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-372-3456
Mailing Address - Street 1:1322 E MICHIGAN AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912
Mailing Address - Country:US
Mailing Address - Phone:517-372-3456
Mailing Address - Fax:517-372-3456
Practice Address - Street 1:1322 E MICHIGAN AVE
Practice Address - Street 2:STE 201
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912
Practice Address - Country:US
Practice Address - Phone:517-372-3456
Practice Address - Fax:517-372-3456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHJ038788207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0331769Medicare ID - Type Unspecified
B43682Medicare UPIN