Provider Demographics
NPI:1316950660
Name:NOROYAN, JEFFREY CHARLES (D P M)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CHARLES
Last Name:NOROYAN
Suffix:
Gender:M
Credentials:D P M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 S DORT HWY
Mailing Address - Street 2:SUITE D
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-2800
Mailing Address - Country:US
Mailing Address - Phone:810-233-5950
Mailing Address - Fax:
Practice Address - Street 1:915 S DORT HWY
Practice Address - Street 2:SUITE D
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2800
Practice Address - Country:US
Practice Address - Phone:810-233-5950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJN001106213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI383456365 052OtherCOMMUNITY CHOICE
MI480B51113OtherBLUE CARE NETWORK
MIC5632OtherMCARE
MIM018866OtherTRICARE
MI480B51113OtherBLUE CROSS BLUE SHIELD
MIT34145OtherRAILROAD MEDICARE
MI4102798Medicaid
MI480B51113OtherBLUE CROSS BLUE SHIELD
MI480B51113OtherBLUE CARE NETWORK