Provider Demographics
NPI:1649227604
Name:VALLE, JOSE MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:MANUEL
Last Name:VALLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:720 US HIGHWAY 27 N
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-9609
Mailing Address - Country:US
Mailing Address - Phone:269-781-6600
Mailing Address - Fax:269-781-9228
Practice Address - Street 1:720 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-9609
Practice Address - Country:US
Practice Address - Phone:269-781-6600
Practice Address - Fax:269-781-9228
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301051479207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB46891Medicare UPIN
MI0A37669Medicare PIN