Provider Demographics
NPI:1578522686
Name:PIERRE-PAUL, JEAN R SR (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:R
Last Name:PIERRE-PAUL
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JEAN
Other - Middle Name:ROMMEL
Other - Last Name:PIERRE-PAUL
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:17260 W 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2949
Mailing Address - Country:US
Mailing Address - Phone:248-809-6553
Mailing Address - Fax:248-809-6583
Practice Address - Street 1:17260 W 10 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2949
Practice Address - Country:US
Practice Address - Phone:248-809-6553
Practice Address - Fax:248-809-6583
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00021071207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine