Provider Demographics
NPI:1790014835
Name:HESS, JEFFERY ELWOOD (MD, MS)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:ELWOOD
Last Name:HESS
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1387 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-3648
Mailing Address - Country:US
Mailing Address - Phone:513-939-8491
Mailing Address - Fax:
Practice Address - Street 1:1170 BORDEAUX DR BLDG 3
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94089-1209
Practice Address - Country:US
Practice Address - Phone:513-939-8491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-21
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0644062083X0100X
CAG1989192083X0100X
MI43011041242083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHF74905Medicare UPIN