Provider Demographics
NPI:1871809798
Name:ERNST, ROBERT JEFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JEFFREY
Last Name:ERNST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:320 MARTIN ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-1486
Mailing Address - Country:US
Mailing Address - Phone:248-737-8600
Mailing Address - Fax:248-737-8601
Practice Address - Street 1:320 MARTIN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-1486
Practice Address - Country:US
Practice Address - Phone:248-737-8600
Practice Address - Fax:248-737-8601
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301060985207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine