Healthcare Provider Details

I. General information

NPI: 1215679170
Provider Name (Legal Business Name): JACQUELINE MEIER COFFMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACQUELINE BARRIE MEIER DO

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 E 14 MILE RD
BIRMINGHAM MI
48009-7256
US

IV. Provider business mailing address

2988 BERKSHIRE DR
BLOOMFIELD HILLS MI
48301-3403
US

V. Phone/Fax

Practice location:
  • Phone: 248-645-1740
  • Fax:
Mailing address:
  • Phone: 248-410-3671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101028627
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: