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NPI Code Detail

MEDICARE: DARWIN EDMOND

MEDICARE: DARWIN EDMOND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1720789589
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARWIN EDMOND
Provider Business Mailing Address
First Line : 300 PORTAGE ST
Second Line :
City : KALAMAZOO
State : MI
Zip : 49007-4929
Country : US
Telephone Number : 269-337-4400
Fax Number :
Provider Business Practice Location Address
First Line : 300 PORTAGE ST
Second Line :
City : KALAMAZOO
State : MI
Zip : 49007-4929
Country : US
Telephone Number : 269-337-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2023
Last Update Date : 03/16/2023

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Directions to “ DARWIN EDMOND ” Practice Location

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