Provider Demographics
NPI:1972533032
Name:OBRON, JEFFREY G (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:G
Last Name:OBRON
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6079 W MAPLE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2283
Mailing Address - Country:US
Mailing Address - Phone:248-535-3221
Mailing Address - Fax:248-325-9613
Practice Address - Street 1:6079 W MAPLE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2283
Practice Address - Country:US
Practice Address - Phone:248-535-3221
Practice Address - Fax:248-325-9613
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIJO043992207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE26142Medicare UPIN
MI0M92560001Medicare ID - Type Unspecified