Healthcare Provider Details

I. General information

NPI: 1922376441
Provider Name (Legal Business Name): SOUTHERN MICHIGAN ORTHOPAEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2011
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 WINSTON DR
MARSHALL MI
49068-8526
US

IV. Provider business mailing address

710 NORTH AVE
BATTLE CREEK MI
49017-3258
US

V. Phone/Fax

Practice location:
  • Phone: 269-969-6251
  • Fax: 269-969-6283
Mailing address:
  • Phone: 269-969-6251
  • Fax: 269-969-6283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM JOSEPH COMAI
Title or Position: RESPONSIBLE PARTY
Credential: D.O.
Phone: 269-969-6251