Provider Demographics
NPI:1821214925
Name:CEDERNA, JEAN BUTLER (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:BUTLER
Last Name:CEDERNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 SAMER RD
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:MI
Mailing Address - Zip Code:48160-9575
Mailing Address - Country:US
Mailing Address - Phone:734-044-0568
Mailing Address - Fax:
Practice Address - Street 1:103 ARNET ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5706
Practice Address - Country:US
Practice Address - Phone:734-481-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065563207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine