Healthcare Provider Details

I. General information

NPI: 1699960013
Provider Name (Legal Business Name): SELECT HEALTH, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 MARSHALL ST
COLDWATER MI
49036-1139
US

IV. Provider business mailing address

436 MARSHALL ST
COLDWATER MI
49036-1139
US

V. Phone/Fax

Practice location:
  • Phone: 517-278-6600
  • Fax: 517-278-0600
Mailing address:
  • Phone: 517-278-6600
  • Fax: 517-278-0600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES F WHITAKER IV
Title or Position: PROVIDER
Credential: M.D.
Phone: 517-278-6600