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DR. JERRY SAMUEL WALDEN M.D. NPI 1427168913


NPI Information

NPI: 1427168913
Provider Name: DR. JERRY SAMUEL WALDEN, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
3174 PACKARD ST
ANN ARBOR, MI
ZIP 48108
Phone: (734) 971-1073
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DR. Jerry Samuel Walden, M.D. is a family medicine in Ann Arbor, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Jerry Samuel Walden, M.D. NPI is 1427168913. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3174 PACKARD ST
ANN ARBOR, MI
ZIP 48108-947
Phone: (734) 971-1073
Fax: (734) 971-8545

The enumeration date for this NPI number is 8/30/2006 and was last updated on 7/9/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineJW027573MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10808172651OTHERMICHIGANBCBS
20817265OTHERMICHIGANBLUE CARE NETWORK
3103791OTHERMICHIGANCARE CHOICES
4B45555OTHERMICHIGANHAP
5B45555MEDICARE UPINMICHIGAN
61639933MEDICAIDMICHIGAN
7C-2855OTHERMICHIGANM-CARE
8OH16245003MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.