Healthcare Provider Details

I. General information

NPI: 1427298173
Provider Name (Legal Business Name): MERCY COMMUNITY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 09/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 FREMONT ST
BATTLE CREEK MI
49017-3389
US

IV. Provider business mailing address

363 FREMONT ST
BATTLE CREEK MI
49017-3389
US

V. Phone/Fax

Practice location:
  • Phone: 269-966-8376
  • Fax:
Mailing address:
  • Phone: 269-966-8376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT H DAVIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 269-966-8309