Healthcare Provider Details

I. General information

NPI: 1447211693
Provider Name (Legal Business Name): HUGO JUARBE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 W. WACKERLY ST
MIDLAND MI
48640
US

IV. Provider business mailing address

419 W. WACKERLY ST
MIDLAND MI
48640
US

V. Phone/Fax

Practice location:
  • Phone: 989-631-9515
  • Fax: 989-835-6824
Mailing address:
  • Phone: 989-631-9515
  • Fax: 989-835-6824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberHJ065344
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: