Healthcare Provider Details

I. General information

NPI: 1144435009
Provider Name (Legal Business Name): DAOUD SURGERY & FAMILY MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

356 E CHICAGO ST SUITE A
COLDWATER MI
49036-2057
US

IV. Provider business mailing address

356 E CHICAGO ST SUITE A
COLDWATER MI
49036-2057
US

V. Phone/Fax

Practice location:
  • Phone: 517-278-3675
  • Fax: 517-279-0049
Mailing address:
  • Phone: 517-278-3675
  • Fax: 517-279-0049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCD51012553
License Number StateMI

VIII. Authorized Official

Name: TRINA MILLER
Title or Position: OFFICE MANAGER
Credential:
Phone: 517-278-2675