Provider Demographics
NPI:1588604854
Name:SOFFA, JEFFREY HARRIS (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:HARRIS
Last Name:SOFFA
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:27745 CORDOBA APT. 1103
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334
Mailing Address - Country:US
Mailing Address - Phone:248-390-6866
Mailing Address - Fax:248-471-3846
Practice Address - Street 1:9619 NEWBURGH RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-2529
Practice Address - Country:US
Practice Address - Phone:734-432-9855
Practice Address - Fax:734-432-9855
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101007116207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine