Female

Jenny S. Radesky MD

Developmental - Behavioral Pediatrics Physician in Ann Arbor, MI(View on Map)

Full Name

Jenny Stillwaggon Radesky MD

NPI Number

1588857999

NPI Type

Individual Provider

Gender

Female

Enumeration Date

08/20/2007

Specialties

(Taxonomies)

Code

2080P0006X
208000000X

Primary Taxonomy

Yes
No

Licenses

State

Massachusetts
Michigan

License Number

246596
4301108770

Contact
Information

Purpose

Mailing
Location

Address

3621 SOUTH STATE STREET
1500 EAST MEDICAL CENTER DR

City

Ann Arbor
Ann Arbor

State

MI
MI

Postal Code

48108
48109-4234

Country

US
US

Telephone Number

(734) 936-2047
(734) 936-4185

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/08/2015

Provider Address

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