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General NPI Number Information
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NPI Number | 1881654671
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Entity Type | Individual
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Provider Name | JAY HOLLANDER MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 3535 W 13 MILE RD STE. 407
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City | ROYAL OAK
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State | MI
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Zip | 48073-6769
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Country | US
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Telephone | 248-551-0638
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Fax | 248-551-4491
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Provider Business Mailing Address
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Address Line | 20952 12 MILE ROAD SUITE 200
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48081-3203
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Country | US
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Telephone | 586-771-4820
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Fax | 586-771-6620
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 4301043235
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License Number State | MI
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