MEDICARE: DR. DEBORAH O JEFFRIES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	4301049569	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326099292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH O JEFFRIES M.D.

Provider Business Mailing Address
First Line	:	3621 S STATE ST
Second Line	:	700 KMS PLACE
City	:	ANN ARBOR
State	:	MI
Zip	:	48108
Country	:	US
Telephone Number	:	734-936-2047
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 EAST MEDICAL CENTER DR
Second Line	:	B1 FLOOR UNIVERSITY HOSPITAL RECP C
City	:	ANN ARBOR
State	:	MI
Zip	:	48109-5030
Country	:	US
Telephone Number	:	734-936-4566
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	03/26/2012

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