Provider Demographics
NPI:1649388307
Name:JEFFREY NOROYAN, P. C.
Entity Type:Organization
Organization Name:JEFFREY NOROYAN, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:NOROYAN
Authorized Official - Suffix:
Authorized Official - Credentials:D P M
Authorized Official - Phone:248-489-1189
Mailing Address - Street 1:28752 WINTERGREEN
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-3034
Mailing Address - Country:US
Mailing Address - Phone:248-489-1189
Mailing Address - Fax:
Practice Address - Street 1:28752 WINTERGREEN
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3034
Practice Address - Country:US
Practice Address - Phone:248-489-1189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJN001106213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4852511360OtherBC/BSM
MI4102751Medicaid
MI4852511360OtherBC/BSM
MI4102751Medicaid
MA=========OtherTIN