Provider Demographics
NPI:1699528471
Name:BABRA, JESSIE GURLEEN (MD)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:GURLEEN
Last Name:BABRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GURLEEN
Other - Middle Name:KAUR
Other - Last Name:BABRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24911 LITTLE MACK, SUITE C
Mailing Address - Street 2:
Mailing Address - City:ST. CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080
Mailing Address - Country:US
Mailing Address - Phone:586-777-2050
Mailing Address - Fax:
Practice Address - Street 1:24911 LITTLE MACK, SUITE C
Practice Address - Street 2:
Practice Address - City:ST. CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080
Practice Address - Country:US
Practice Address - Phone:586-777-2050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program