Provider Demographics
NPI:1669408613
Name:BELKIN, JEFFREY L (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
Last Name:BELKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30123 HIGH VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-2169
Mailing Address - Country:US
Mailing Address - Phone:248-318-6898
Mailing Address - Fax:279-365-0233
Practice Address - Street 1:29877 TELEGRAPH ROAD
Practice Address - Street 2:STE L-12
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-7657
Practice Address - Country:US
Practice Address - Phone:248-213-6222
Practice Address - Fax:279-365-0233
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301039946207L00000X
MI4031039946207L00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology