Jeromy Lee Balduf, PA-C, RDN

NPI #1003561309 in Ottawa Lake, Michigan

Provider Information

NPI Number: 1003561309
Entity Type: Individual
Name: Jeromy Lee Balduf, PA-C, RDN
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA-C, RDN
Enumeration Date: Feb 15, 2022
Last Updated: Feb 15, 2022

Practice Location

Address: 6400 LEORA LN
City: Ottawa Lake
State: Michigan
ZIP Code: 49267-9627
Phone: (419) 356-6458

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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