Provider Demographics
NPI:1235367269
Name:ERNEST, JEANINE (MD)
Entity Type:Individual
Prefix:DR
First Name:JEANINE
Middle Name:
Last Name:ERNEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E WARWICK DR
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1012
Mailing Address - Country:US
Mailing Address - Phone:989-463-5876
Mailing Address - Fax:989-466-5956
Practice Address - Street 1:200 E WARWICK DR
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1012
Practice Address - Country:US
Practice Address - Phone:989-463-5876
Practice Address - Fax:989-466-5956
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092777207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine