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NPI Code Detail

MEDICARE: JONATHAN BARDELOZA TOJE

MEDICARE: JONATHAN BARDELOZA TOJE
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
1163WC0200XCritical Care Medicine Registered Nurse4704300943MI
2367500000XCertified Registered Nurse Anesthetist4704300934MI

General Provider Information

NPI Number : 1760027825
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN BARDELOZA TOJE
Provider Business Mailing Address
First Line : 303 E KEARSLEY ST
Second Line :
City : FLINT
State : MI
Zip : 48502-1950
Country : US
Telephone Number : 248-259-9429
Fax Number :
Provider Business Practice Location Address
First Line : 303 E KEARSLEY ST
Second Line :
City : FLINT
State : MI
Zip : 48502-1950
Country : US
Telephone Number : 248-259-9429
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2019
Last Update Date : 10/15/2024

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Directions to “ JONATHAN BARDELOZA TOJE ” Practice Location

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