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General NPI Number Information
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NPI Number | 1700964715
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Entity Type | Organization
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Legal Business Name | GLORIA JUE DO PC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 05/27/2021
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Provider Practice Location Address
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Address Line | 1335 S LINDEN RD SUITE B
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City | FLINT
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State | MI
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Zip | 48532-3420
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Country | US
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Telephone | 810-733-5090
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Fax | 810-733-5093
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Provider Business Mailing Address
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Address Line | 1335 S LINDEN RD SUITE B
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City | FLINT
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State | MI
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Zip | 48532-3420
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Country | US
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Telephone | 810-733-5090
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Fax | 810-733-5093
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GLORIA JUE
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Credential | DO
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Telephone | 810-733-5090
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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 | GJ007218
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License Number State | MI
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