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NPI Code Detail

MEDICARE: DIGESTIVE HEALTH ASSOCIATES OF SOUTHWEST MICHIGAN, P.C.

MEDICARE: DIGESTIVE HEALTH ASSOCIATES OF SOUTHWEST MICHIGAN, P.C.
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
1207RG0100XGastroenterology Physician

General Provider Information

NPI Number : 1851569958
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIGESTIVE HEALTH ASSOCIATES OF SOUTHWEST MICHIGAN, P.C.
Provider Business Mailing Address
First Line : 3304 COOLEY CT
Second Line :
City : PORTAGE
State : MI
Zip : 49024-7430
Country : US
Telephone Number : 269-349-2266
Fax Number : 269-349-0792
Provider Business Practice Location Address
First Line : 3304 COOLEY CT
Second Line :
City : PORTAGE
State : MI
Zip : 49024-7430
Country : US
Telephone Number : 269-349-2266
Fax Number : 269-349-0792
Authorized Official
Title or Position : PRESIDENT
Name : WILLIAM F HANAVAN
Credential : M.D.
Telephone Number : 269-349-2266
Provider Enumeration Date : 02/12/2008
Last Update Date : 02/12/2008

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Directions to “DIGESTIVE HEALTH ASSOCIATES OF SOUTHWEST MICHIGAN, P.C. ” Practice Location

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