Provider Demographics
NPI:1912998394
Name:VOELPEL, MARY JO K (DO)
Entity Type:Individual
Prefix:MRS
First Name:MARY JO
Middle Name:K
Last Name:VOELPEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:P.O. BOX 318
Mailing Address - Street 2:3003 S. BALDWIN RD. SUITE A
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48359
Mailing Address - Country:US
Mailing Address - Phone:248-391-9220
Mailing Address - Fax:248-391-9224
Practice Address - Street 1:3003 S. BALDWIN RD.
Practice Address - Street 2:SUITE A
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48359
Practice Address - Country:US
Practice Address - Phone:248-391-9220
Practice Address - Fax:248-391-9224
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2015-01-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIMV006984207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI122064-0003OtherWELLNESS
MI23D089621OtherCLIA
MI103416OtherGREAT LAKES
MI103779OtherCARE CHOICE
MIP00061141OtherRR MEDICARE
MI4217OtherCAPE HEALTH
MIP44577OtherBCN
MI4441531OtherTEAMSTERS
MI1156300864OtherBCBS
MIC4930OtherMCARE
MI(11)4509816Medicaid
MI383460440OtherPPOM
MI50016867OtherHAP
MI103416OtherGREAT LAKES
MI122064-0003OtherWELLNESS