Healthcare Provider Details

I. General information

NPI: 1891817136
Provider Name (Legal Business Name): MEDPLUS P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 LAURENCE AVE
JACKSON MI
49202-2966
US

IV. Provider business mailing address

875 LAURENCE AVE
JACKSON MI
49202-2966
US

V. Phone/Fax

Practice location:
  • Phone: 517-787-0544
  • Fax: 517-787-0730
Mailing address:
  • Phone: 517-787-0544
  • Fax: 517-787-0730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN KREMER
Title or Position: MANAGER
Credential:
Phone: 248-496-8574