MEDICARE: DR. JEFFREY ERDMAN BULLER D.C.,D.A.C.S.

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
1	111N00000X	Chiropractor	2301004622	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0F35234	OTHER	MI	BCBS OF MI
2	5902400	OTHER	MI	AETNA PROVIDER #

General Provider Information

NPI Number	:	1972630465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY ERDMAN BULLER D.C.,D.A.C.S.

Provider Business Mailing Address
First Line	:	294 W TIENKEN RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-4404
Country	:	US
Telephone Number	:	248-652-9191
Fax Number	:	248-652-9739

Provider Business Practice Location Address
First Line	:	294 W TIENKEN RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-4404
Country	:	US
Telephone Number	:	248-652-9191
Fax Number	:	248-652-9739

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	07/09/2007

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