Provider Demographics
NPI:1154340693
Name:POSTMA, JEFFREY T (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:T
Last Name:POSTMA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6559 PAW PAW AVE
Mailing Address - Street 2:
Mailing Address - City:COLOMA
Mailing Address - State:MI
Mailing Address - Zip Code:49038-8805
Mailing Address - Country:US
Mailing Address - Phone:269-463-3600
Mailing Address - Fax:269-468-3334
Practice Address - Street 1:6559 PAW PAW AVE
Practice Address - Street 2:
Practice Address - City:COLOMA
Practice Address - State:MI
Practice Address - Zip Code:49038-8805
Practice Address - Country:US
Practice Address - Phone:269-463-3600
Practice Address - Fax:269-468-3334
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101011309207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3363566Medicaid
MI3363566Medicaid
MIF32435Medicare UPIN
MI0H06003Medicare PIN