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General NPI Number Information
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NPI Number | 1427756626
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Entity Type | Individual
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Provider Name | MICHAEL J JAEGER PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/17/2023
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 2480 WHITE BEAR AVE N STE 104
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City | MAPLEWOOD
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State | MN
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Zip | 55109-4568
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Country | US
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Telephone | 612-444-3247
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Fax | 612-888-9247
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Provider Business Mailing Address
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Address Line | 2480 WHITE BEAR AVE N STE 104
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City | MAPLEWOOD
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State | MN
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Zip | 55109-4568
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Country | US
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Telephone | 612-444-3247
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Fax | 612-888-9247
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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