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General NPI Number Information
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NPI Number | 1174253306
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Entity Type | Individual
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Provider Name | JENNIE DEBLANC MD
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Gender | Female
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Dates
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Enumeration Date | 06/11/2022
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 1540 E MEDICAL CENTER DR
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City | ANN ARBOR
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State | MI
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Zip | 48109-0100
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Country | US
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Telephone | 734-936-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 3065 VILLAGE CIR N
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City | ANN ARBOR
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State | MI
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Zip | 48108-2098
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Country | US
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Telephone | 616-795-6851
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4351049151
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License Number State | MI
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