Provider Demographics
NPI:1083886493
Name:JENNIFER L. OZEIR, M.D., P.C.
Entity Type:Organization
Organization Name:JENNIFER L. OZEIR, M.D., P.C.
Other - Org Name:WOMEN'S HEALTH OF DEARBORN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:OZEIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PC
Authorized Official - Phone:313-561-2200
Mailing Address - Street 1:16853 W OUTER DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2485
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23100 CHERRY HILL ST STE 9
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1449
Practice Address - Country:US
Practice Address - Phone:313-561-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2009-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077124207V00000X, 302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No302F00000XManaged Care OrganizationsExclusive Provider OrganizationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI160H241050OtherBCBSM/BCN
MI160H241050OtherBCBSM/BCN