Provider Demographics
NPI:1467480186
Name:SEGERSON, JAMES CROWLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CROWLEY
Last Name:SEGERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 AMERICAN RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2701
Mailing Address - Country:US
Mailing Address - Phone:313-322-1131
Mailing Address - Fax:313-845-8659
Practice Address - Street 1:1 AMERICAN RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2701
Practice Address - Country:US
Practice Address - Phone:313-322-1131
Practice Address - Fax:313-845-8659
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI048774207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine