Healthcare Provider Details

I. General information

NPI: 1578805271
Provider Name (Legal Business Name): NORTH POINTE FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2298 SPRINGPORT RD SUITE A
JACKSON MI
49202-1475
US

IV. Provider business mailing address

2298 SPRINGPORT RD SUITE A
JACKSON MI
49202-1475
US

V. Phone/Fax

Practice location:
  • Phone: 517-945-8164
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5601003014
License Number StateMI

VIII. Authorized Official

Name: STEVEN S GARVER
Title or Position: OWNER
Credential: PA
Phone: 517-945-8164