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NPI Code Detail

MEDICARE: DR. GINA Y JORDAN MD

MEDICARE: DR. GINA Y JORDAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PE0004XEmergency Medical Services (Emergency Medicine) Physician24049SC
2207R00000XInternal Medicine Physician24049SC
3207P00000XEmergency Medicine Physician24049SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
157 1060903OTHERTAX ID
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225032741
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GINA Y JORDAN MD
Provider Business Mailing Address
First Line : 2215 FULLER RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-2303
Country : US
Telephone Number : 734-769-7100
Fax Number :
Provider Business Practice Location Address
First Line : 2215 FULLER RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-2303
Country : US
Telephone Number : 734-769-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 08/14/2025

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