Provider Demographics
NPI:1376725184
Name:JUNI, JACK EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:EDWARD
Last Name:JUNI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7444 N HAGGERTY RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2437
Mailing Address - Country:US
Mailing Address - Phone:248-640-9849
Mailing Address - Fax:734-207-3446
Practice Address - Street 1:7444 N HAGGERTY RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2437
Practice Address - Country:US
Practice Address - Phone:248-640-9849
Practice Address - Fax:734-207-3446
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301046408207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine