Provider Demographics
NPI:1902341043
Name:ALEX, JOJI (NP-C)
Entity type:Individual
Prefix:
First Name:JOJI
Middle Name:
Last Name:ALEX
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13967 PATTERSON DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-4259
Mailing Address - Country:US
Mailing Address - Phone:586-556-0917
Mailing Address - Fax:
Practice Address - Street 1:3081 COMMERCE DR STE 400
Practice Address - Street 2:
Practice Address - City:FORT GRATIOT
Practice Address - State:MI
Practice Address - Zip Code:48059-3868
Practice Address - Country:US
Practice Address - Phone:810-364-5050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-28
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF1216019363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily