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General NPI Number Information
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NPI Number | 1790965838
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Entity Type | Organization
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Legal Business Name | JOHN A. VOLLMER, MD, PC
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 25250 KELLY RD
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City | ROSEVILLE
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State | MI
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Zip | 48066-4473
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Country | US
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Telephone | 586-777-4668
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Fax | 586-777-4452
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Provider Business Mailing Address
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Address Line | 25250 KELLY RD
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City | ROSEVILLE
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State | MI
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Zip | 48066-4473
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Country | US
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Telephone | 586-777-4668
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Fax | 586-777-4452
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN ANTHONY VOLLMER
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Credential | MD
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Telephone | 586-777-4668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | JV046289
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License Number State | MI
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