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Contact Information

JENNIFER C MAXAM FENNER, DO
419 W. WACKERLY ST
MIDLAND, MI48640
 Phone: 989-631-9515
 Fax: 989-835-6824
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for JENNIFER C MAXAM FENNER · (Female)

NPI Number 1679542922
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 03/17/2006
Last updated 07/10/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MI License # JG013790
  • MI Medicaid 4287010
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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