Healthcare Provider Details

I. General information

NPI: 1154340693
Provider Name (Legal Business Name): JEFFREY T POSTMA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 11/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6559 PAW PAW AVE
COLOMA MI
49038-8805
US

IV. Provider business mailing address

6559 PAW PAW AVE
COLOMA MI
49038-8805
US

V. Phone/Fax

Practice location:
  • Phone: 269-463-3600
  • Fax: 269-468-3334
Mailing address:
  • Phone: 269-463-3600
  • Fax: 269-468-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number5101011309
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: