| NPI | 1063528958 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2006-08-22 |
| Last Updated | 2013-12-10 |
| Mailing Address | 888 West Big Beaver Road, Suite 480 Troy, MI 48084-4764 United States Phone: (248) 797-8324 | Fax: (248) 816-5173 📍 View Map |
| Primary Practice Address | 5700 E 11 Mile Road, Suite C Warren, MI 48089 United States Phone: (586) 558-4482 | Fax: (586) 558-8923 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | — | 2555002114BX33 | BC/BS |
| MEDICAID | MI | 3742088 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 111N00000X – Chiropractor | MI | 2301003007 |
| Yes | 208100000X – Physical Medicine & Rehabilitation | MI | 5101012371 |
| No | 208100000X – Physical Medicine & Rehabilitation | NY | 2238841 |
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About NPI 1063528958
Jeffrey Edwin Middeldorf D.O. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1063528958. The primary specialty listed is Physical Medicine & Rehabilitation. The provider is located in Warren, MI. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-08-22. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1063528958?
NPI 1063528958 belongs to Jeffrey Edwin Middeldorf D.O., a Physical Medicine & Rehabilitation in Warren, MI. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1063528958 active?
The current status of NPI 1063528958 in the NPPES registry is Active. The record was last updated on 2013-12-10.
What specialty is NPI 1063528958?
NPI 1063528958 is classified under the taxonomy Physical Medicine & Rehabilitation. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1063528958?
You can verify NPI 1063528958 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1063528958?
The primary practice address on file for NPI 1063528958 is 5700 E 11 Mile Road, Warren, MI 48089. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1063528958 issued?
NPI 1063528958 was first issued (enumerated) on 2006-08-22. The NPPES record was last updated on 2013-12-10.
Practice Location Map
Jeffrey Edwin Middeldorf is located at 5700 E 11 Mile Road, Warren, MI. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Jeffrey Edwin Middeldorf. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1063528958. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Chiropractor | 2301003007 | MI |
| Physical Medicine & Rehabilitation | 5101012371 | MI |
| Physical Medicine & Rehabilitation | 2238841 | NY |