Healthcare Provider Details

I. General information

NPI: 1295226579
Provider Name (Legal Business Name): JEFFREY PAUL BIEHL RN, MSN, CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44249 DEQUINDRE RD.
TROY MI
48085
US

IV. Provider business mailing address

23424 GROVE ST
SAINT CLAIR SHORES MI
48080-3232
US

V. Phone/Fax

Practice location:
  • Phone: 248-964-5000
  • Fax:
Mailing address:
  • Phone: 810-923-6735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704295907
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: