Healthcare Provider Details

I. General information

NPI: 1841214541
Provider Name (Legal Business Name): JONATHAN W.T AYERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3145 W CLARK RD SUITE 301
YPSILANTI MI
48197-1120
US

IV. Provider business mailing address

2120 AUTUMN HILL DR
ANN ARBOR MI
48103-2176
US

V. Phone/Fax

Practice location:
  • Phone: 734-434-4766
  • Fax:
Mailing address:
  • Phone: 734-747-8645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301040435
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: