Provider Demographics
NPI:1306815261
Name:JUE, GLORIA (DO)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:
Last Name:JUE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:GLORIA
Other - Middle Name:
Other - Last Name:JUE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1335 S LINDEN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3420
Mailing Address - Country:US
Mailing Address - Phone:810-733-5090
Mailing Address - Fax:810-733-5093
Practice Address - Street 1:1335 S LINDEN RD
Practice Address - Street 2:SUITE B
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3420
Practice Address - Country:US
Practice Address - Phone:810-733-5090
Practice Address - Fax:810-733-5093
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIGJ007218174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIQMXPR00205OtherMOLINA
MI1J56053OtherHEALTH PLUS OF MICHIGAN
MIC5276OtherMCARE
MI1652508580OtherBLUE CARE NETWORK
MI1J56053OtherHAP
MI1652508580OtherBCBS
MI1842869Medicaid
MI5250858OtherRAILROAD MEDICARE
MI1652508580OtherBLUE CARE NETWORK
MIQMXPR00205OtherMOLINA