Provider Demographics
NPI:1730167800
Name:SENDI, JEFFREY ALAN (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:SENDI
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:6549 TOWN CENTER DR
Mailing Address - Street 2:CREDENTIALING/PAYER CONTRACTING SERVICES
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-4824
Mailing Address - Country:US
Mailing Address - Phone:248-620-6400
Mailing Address - Fax:248-620-6405
Practice Address - Street 1:42669 GARFIELD RD
Practice Address - Street 2:EMERGENCY MEDICINE DEPARTMENT
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-5036
Practice Address - Country:US
Practice Address - Phone:586-412-5321
Practice Address - Fax:586-412-5327
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2012-06-12
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Provider Licenses
StateLicense IDTaxonomies
MI5101013688207P00000X
MI5101011688207P00000X
VA0102202280207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1730167800Medicaid
MIF63732Medicare UPIN