Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jack Michael Tietema, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1326669391

Dr. Jack Michael Tietema, MD is a Student in an Organized Health Care Education/Training Program in Philadelphia, Pennsylvania. Practices as a sole proprietor. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Philadelphia, PA
Fax: (215) 615-3995

No coordinates on file. Search this address in Google Maps

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1326669391
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMay 1, 2020
Last updated in NPPESMay 5, 2026
Certification dateMay 5, 2026

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