Provider Demographics
NPI:1154559177
Name:BIHN, JASON WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:WILLIAM
Last Name:BIHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15350 TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2027
Mailing Address - Country:US
Mailing Address - Phone:734-283-4616
Mailing Address - Fax:734-283-5430
Practice Address - Street 1:15350 TRENTON RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2027
Practice Address - Country:US
Practice Address - Phone:734-283-4616
Practice Address - Fax:734-283-5430
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.099525208000000X
MI4301110989208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0068114Medicaid