Provider Demographics
NPI:1043567902
Name:MARY JO K. VOELPEL DO PC
Entity Type:Organization
Organization Name:MARY JO K. VOELPEL DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY JO
Authorized Official - Middle Name:K
Authorized Official - Last Name:VOELPEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-391-9220
Mailing Address - Street 1:3003 S BALDWIN RD STE A
Mailing Address - Street 2:
Mailing Address - City:ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48359-2358
Mailing Address - Country:US
Mailing Address - Phone:248-391-9220
Mailing Address - Fax:248-391-9224
Practice Address - Street 1:3003 S BALDWIN RD
Practice Address - Street 2:SUITE A
Practice Address - City:ORION
Practice Address - State:MI
Practice Address - Zip Code:48359-2358
Practice Address - Country:US
Practice Address - Phone:248-391-9220
Practice Address - Fax:248-391-9224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-10
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMV006984207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1912998394Medicare UPIN