Healthcare Provider Details

I. General information

NPI: 1114808466
Provider Name (Legal Business Name): LDMAX HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W MICHIGAN AVE STE D
MARSHALL MI
49068-1586
US

IV. Provider business mailing address

93 SUNNYSIDE DR
BATTLE CREEK MI
49015-3154
US

V. Phone/Fax

Practice location:
  • Phone: 269-268-0410
  • Fax: 269-969-1989
Mailing address:
  • Phone: 248-462-0684
  • 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 Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE ODELL
Title or Position: BILLING SPECIALIST
Credential:
Phone: 248-462-0684