Active NPI 1790725158 Individual Practitioner Male Practitioner

Dr. Mohan Ganesh Kulkarni , MD

Surgery • Jackson, MI

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Mohan Kulkarni, MD is a certified Surgery practicing in Jackson, MI. With approximately 41 years of clinical experience since completing medical education in 1985, Dr. Kulkarni delivers high-quality medical care to the local community at 900 E MICHIGAN AVE.

Dr. Kulkarni is affiliated with W. A. Foote Memorial Hospital, Inc. and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, subsequent hospital care with moderate levelof medical decision making, if using time, at least, biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

900 E Michigan Ave
Suite 103

Jackson, MI 492012457

Telephone 5177886007

Fax 5177886438

Associated Practice Facility / Clinic

🏢 Pulmonary Clinics Of Southern Michigan Facility NPI 1992818207

Medicare Profile & Education

Medical School

Other

Graduation Year

1985

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Jackson, MI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

41 Yrs +12.7 yrs vs City Avg

City Avg: 28.3 Yrs

State Avg: 25.8 Yrs

Regional Practice Density

13 Specialists

Practicing in Jackson, MI (1479 Statewide)

Telehealth Adoption Rate

7.7% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

69.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Kulkarni (41 Years) 41 Yrs

Jackson Specialty Average (28.3 Years) 28.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	96	80	$111.88	$91.07
99213 Established patient office or other outpatient visit, typically 15 minutes	60	52	$77.85	$61.10
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	57	23	$228.00	$75.43
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	52	49	$460.00	$101.00
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	32	30	$432.00	$122.07
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	28	28	$152.82	$127.94
43248 Insertion of guide wire with dilation of esophagus using a flexible endoscope	27	25	$550.00	$153.77
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	25	25	$1120.00	$310.86
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	24	24	$69.00	$17.23
32555 Aspiration of fluid from chest cavity using imaging guidance	21	12	$377.14	$103.79
99441 Telephone medical discussion with physician, 5-10 minutes	17	16	$78.00	$52.88
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	13	12	$640.00	$165.81
32674 Removal of lymph nodes of chest cavity using an endoscope	13	13	$740.00	$208.88
31652 Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes	11	11	$720.00	$183.47

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	202	148	$108.48	$93.44
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	55	53	$460.00	$107.31
43248 Insertion of guide wire with dilation of esophagus using a flexible endoscope	47	41	$550.00	$153.92
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	42	42	$155.67	$128.92
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	35	35	$1120.00	$320.39
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	35	35	$432.00	$123.20
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	35	35	$69.00	$17.45
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	32	18	$228.00	$76.47
32555 Aspiration of fluid from chest cavity using imaging guidance	27	13	$360.00	$101.10
99213 Established patient office or other outpatient visit, typically 15 minutes	26	25	$79.19	$63.66
31652 Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes	20	20	$720.00	$195.23
99231 Follow-up hospital inpatient care per day, typically 15 minutes	19	15	$125.00	$48.26
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	17	17	$5379.97	$1506.32
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	16	14	$640.00	$167.65
32674 Removal of lymph nodes of chest cavity using an endoscope	15	15	$740.00	$208.09
32608 Biopsy of growths in one lung using an endoscope	11	11	$1290.00	$366.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	245	179	$107.62	$96.90
99231 Follow-up hospital inpatient care per day, typically 15 minutes	81	35	$125.00	$37.95
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	62	62	$148.45	$133.77
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	54	50	$460.00	$89.90
43248 Insertion of guide wire with dilation of esophagus using a flexible endoscope	45	42	$550.00	$160.74
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	41	41	$69.00	$18.46
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	40	40	$1120.00	$332.37
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	32	31	$640.00	$193.94
32555 Aspiration of fluid from chest cavity using imaging guidance	28	18	$360.00	$109.42
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	27	27	$432.00	$133.10
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	24	24	$5357.23	$1479.43
32674 Removal of lymph nodes of chest cavity using an endoscope	24	24	$740.00	$215.93
31652 Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes	21	21	$720.00	$209.80
99213 Established patient office or other outpatient visit, typically 15 minutes	16	16	$77.69	$63.09
32608 Biopsy of growths in one lung using an endoscope	13	13	$1290.00	$376.46
43246 Insertion of stomach tube using a flexible endoscope	12	12	$670.00	$147.94
32663 Examination of lung with removal of lung lobe using an endoscope	11	11	$4780.00	$1412.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	260	182	$108.70	$98.00
99231 Follow-up hospital inpatient care per day, typically 15 minutes	69	32	$125.00	$37.90
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	59	59	$150.44	$135.33
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	57	52	$460.00	$91.50
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	51	51	$1120.00	$332.71
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	51	51	$69.00	$18.66
43248 Insertion of guide wire with dilation of esophagus using a flexible endoscope	42	38	$550.00	$157.07
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	36	29	$155.00	$142.91
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	33	32	$640.00	$197.44
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	30	18	$228.00	$70.84
99213 Established patient office or other outpatient visit, typically 15 minutes	29	27	$71.00	$67.04
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	27	27	$432.00	$134.16
32555 Aspiration of fluid from chest cavity using imaging guidance	23	16	$360.00	$111.19
32674 Removal of lymph nodes of chest cavity using an endoscope	22	22	$740.00	$217.55
31652 Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes	22	22	$720.00	$200.79
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	21	21	$202.10	$176.41
43246 Insertion of stomach tube using a flexible endoscope	16	16	$670.00	$148.52
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	15	15	$5478.73	$1492.38
32663 Examination of lung with removal of lung lobe using an endoscope	14	14	$4780.00	$1335.78
32608 Biopsy of growths in one lung using an endoscope	14	14	$1290.00	$380.88
32551 Removal of fluid from between lung and chest cavity	13	11	$570.77	$157.74
99442 Telephone medical discussion with physician, 11-20 minutes	11	11	$80.27	$67.10

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	223	176	$89.36	$79.08
99231 Follow-up hospital inpatient care per day, typically 15 minutes	76	36	$125.00	$39.38
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	49	46	$460.00	$102.26
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	48	47	$190.46	$168.33
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	41	40	$69.00	$18.90
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	39	38	$640.00	$202.79
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	39	39	$1120.00	$330.61
43248 Insertion of guide wire with dilation of esophagus using a flexible endoscope	33	30	$550.00	$163.80
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	26	25	$432.00	$138.03
31652 Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes	26	25	$720.00	$214.96
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	24	21	$130.92	$112.29
99443 Telephone medical discussion with physician, 21-30 minutes	21	20	$116.00	$79.57
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$148.70	$129.62
32674 Removal of lymph nodes of chest cavity using an endoscope	19	19	$740.00	$223.20
32608 Biopsy of growths in one lung using an endoscope	19	19	$1290.00	$391.51
43246 Insertion of stomach tube using a flexible endoscope	18	17	$670.00	$147.92
32555 Aspiration of fluid from chest cavity using imaging guidance	16	15	$360.00	$111.22
99442 Telephone medical discussion with physician, 11-20 minutes	16	16	$79.00	$51.79
99213 Established patient office or other outpatient visit, typically 15 minutes	16	13	$90.94	$51.39
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	15	15	$5302.00	$1544.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	290	209	$87.95	$77.73
99231 Follow-up hospital inpatient care per day, typically 15 minutes	67	29	$124.78	$38.98
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	63	63	$1226.70	$333.96
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	61	61	$146.08	$127.72
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	60	59	$564.18	$111.18
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	54	33	$216.67	$71.92
43248 Insertion of guide wire with dilation of esophagus using a flexible endoscope	53	41	$551.19	$169.90
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	51	50	$69.00	$18.67
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	46	46	$187.80	$166.65
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	42	40	$417.33	$135.47
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	41	40	$628.15	$196.17
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	33	33	$5110.08	$1574.51
32674 Removal of lymph nodes of chest cavity using an endoscope	33	33	$707.27	$220.88
32608 Biopsy of growths in one lung using an endoscope	27	26	$1281.11	$384.71
99213 Established patient office or other outpatient visit, typically 15 minutes	23	19	$65.61	$50.53
31652 Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes	18	17	$693.78	$206.15
32663 Examination of lung with removal of lung lobe using an endoscope	17	17	$4716.47	$1381.23
99221 Initial hospital inpatient care per day, typically 30 minutes	17	17	$295.53	$100.46
43246 Insertion of stomach tube using a flexible endoscope	12	12	$670.00	$128.32
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	12	$121.42	$109.76
64421 Injection of anesthetic agent and/or steroid into multiple rib nerves for regional nerve block	12	12	$195.50	$92.37
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	11	11	$160.00	$51.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	301	203	$81.23	$76.97
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	112	59	$160.00	$70.76
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	82	74	$1353.00	$90.61
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	75	69	$376.00	$132.44
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	74	74	$138.85	$124.51
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	55	55	$4481.00	$384.90
43248 Insertion of guide wire with dilation of esophagus using a flexible endoscope	51	40	$557.00	$166.86
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	44	24	$246.00	$102.30
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	33	33	$175.00	$165.82
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	31	31	$102.94	$18.45
32674 Removal of lymph nodes of chest cavity using an endoscope	31	30	$380.00	$217.93
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	26	25	$478.00	$192.15
32666 Initial removal of wedge of lung tissue using an endoscope	25	23	$2370.00	$870.65
99231 Follow-up hospital inpatient care per day, typically 15 minutes	25	16	$120.00	$38.52
32555 Aspiration of fluid from chest cavity using imaging guidance	22	17	$125.45	$108.25
64421 Injection of anesthetic agent and/or steroid into multiple rib nerves for regional nerve block	19	18	$96.00	$86.46
32663 Examination of lung with removal of lung lobe using an endoscope	18	18	$3700.00	$1367.27
43246 Insertion of stomach tube using a flexible endoscope	17	17	$470.00	$143.69
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	17	17	$2870.00	$1501.47
32554 Removal of fluid from chest cavity	14	13	$95.00	$86.98
99221 Initial hospital inpatient care per day, typically 30 minutes	14	14	$216.00	$99.61
31652 Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes	14	14	$248.00	$214.60
99213 Established patient office or other outpatient visit, typically 15 minutes	11	11	$57.73	$50.23

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	213	172	$81.00	$76.61
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	109	103	$1353.00	$87.13
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	89	78	$115.00	$108.68
43248 Insertion of guide wire with dilation of esophagus using a flexible endoscope	70	58	$557.00	$160.83
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	69	69	$175.00	$165.17
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	59	59	$4481.00	$329.51
99221 Initial hospital inpatient care per day, typically 30 minutes	54	52	$216.00	$99.13
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	42	42	$135.00	$126.66
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	34	25	$161.47	$70.41
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	26	26	$376.00	$133.60
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	26	26	$289.00	$18.69
32666 Initial removal of wedge of lung tissue using an endoscope	25	23	$2370.00	$836.78
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	21	19	$478.00	$197.74
99213 Established patient office or other outpatient visit, typically 15 minutes	21	21	$55.48	$49.73
43246 Insertion of stomach tube using a flexible endoscope	21	20	$849.52	$139.80
32663 Examination of lung with removal of lung lobe using an endoscope	19	19	$3700.00	$1353.60
32555 Aspiration of fluid from chest cavity using imaging guidance	19	15	$893.58	$103.56
32674 Removal of lymph nodes of chest cavity using an endoscope	17	17	$380.00	$217.56
64421 Injection of anesthetic agent and/or steroid into multiple rib nerves for regional nerve block	16	15	$502.25	$87.69
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	15	15	$2870.00	$1454.90
31654 Examination of lung airways using an endoscope with imaging guidance and ultrasound	14	14	$230.00	$67.94
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$80.00	$74.98
31600 Opening of windpipe through neck for insertion of breathing tube	14	13	$994.00	$372.06
43282 Repair of hernia of muscle at esophagus and stomach with implantation of mesh using an endoscope	12	12	$3230.00	$1737.93

Medical Specialties & State Licenses

CMS Verified: 2023-10-04

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License MI 4301066998

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Thoracic Surgery (Cardiothoracic Vascular Surgery)

NUCC Taxonomy Code: 208G00000X

State License MI 4301066998

A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID State License

MK066998 (MI)

Hospital & Practice Group Affiliations

W. A. Foote Memorial Hospital, Inc.

813 W Michigan Ave, Jackson, MI 492014158

Phone: 5172056430

W. A. Foote Memorial Hospital, Inc.

205 N E Ave, Jackson, MI 492011753

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners

Renee Hendrick , ANP

Nurse Practitioner - Adult Health

NPI 1295082030

Adult Nurse Practitioner

Dr. Bruce Barbour , MD

Internal Medicine

NPI 1386602761

Doctor of Medicine (M.D.)

Dr. Harish Rawal , MD

Neurological Surgery

NPI 1396768693

Doctor of Medicine (M.D.)

Dr. Robert Albertson , MD

Internal Medicine - Pulmonary Disease

NPI 1487610481

Doctor of Medicine (M.D.)

Dr. Rami Alzebdeh , MD

Internal Medicine - Pulmonary Disease

NPI 1497954598

Doctor of Medicine (M.D.)

Emily Killian

Nurse Practitioner - Family

NPI 1598363475

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 04, 2023

Thoracic Surgery (Cardiothoracic Vascular Surgery) (License #4301066998 in MI)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 900 E MICHIGAN AVE, SUITE 103, JACKSON, MI 492012457 (Tel: 5177886007)

📍

Updated Business Mailing Address July 08, 2007

Registered at 900 E MICHIGAN AVE, SUITE 103, JACKSON, MI 492012457 (Tel: 5177886007)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as MOHAN KULKARNI, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Thoracic Surgery (Cardiothoracic Vascular Surgery) (License #MK066998 in MI)

🟢

Initial NPI Registration & Enumeration June 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1790725158

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 07, 2006

Last Update: October 04, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

900 E Michigan Ave, Suite 103

Jackson, MI 492012457

Phone: 5177886007

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.