Provider Demographics
NPI:1215679170
Name:COFFMAN, JACQUELINE MEIER (DO)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:MEIER
Last Name:COFFMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:BARRIE
Other - Last Name:MEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2988 BERKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-3403
Mailing Address - Country:US
Mailing Address - Phone:248-410-3671
Mailing Address - Fax:
Practice Address - Street 1:2055 E 14 MILE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-7256
Practice Address - Country:US
Practice Address - Phone:248-645-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI5101028627208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program