Provider Demographics
NPI:1417055229
Name:DEMBS, JEFFREY LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LEE
Last Name:DEMBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:41935 W TWELVE MILE ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-3111
Mailing Address - Country:US
Mailing Address - Phone:248-347-8040
Mailing Address - Fax:248-305-6179
Practice Address - Street 1:41935 W TWELVE MILE ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-3111
Practice Address - Country:US
Practice Address - Phone:248-347-8040
Practice Address - Fax:248-305-6179
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301038046208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics