| Organization Name: | JESUS ORTEGA, M.D., P.L.L.C. |
| NPI Number: | 1154502243 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JESUS ORTEGA (OWNER) |
| Mailing Address: | 6760 Allen Rd Suite 106 Allen Park |
| State: | MI US |
| Postal Code: | 481012078 |
| Phone Number: | 3133815522 |
| Fax Number: | 3133812666 |
| NPI Enumeration Date: | 11/17/2007 |
| NPI Last Update Date: | 11/17/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RH0003X |
| License Number: | JO4301031455 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Hematology & Oncology |
| Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |