Provider Demographics
NPI:1033191937
Name:PLACZEK, JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:PLACZEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26750 PROVIDENCE PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1212
Mailing Address - Country:US
Mailing Address - Phone:248-596-0412
Mailing Address - Fax:248-596-0418
Practice Address - Street 1:26750 PROVIDENCE PKWY STE 220
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1212
Practice Address - Country:US
Practice Address - Phone:248-596-0412
Practice Address - Fax:248-596-0418
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301071986207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI400000770OtherRAILROAD MEDICARE
MIH87848Medicare UPIN
MI0N95100002Medicare PIN
MI400000770OtherRAILROAD MEDICARE
MI5812140001Medicare NSC