Healthcare Provider Details

I. General information

NPI: 1003445263
Provider Name (Legal Business Name): KYLE NATHANIEL TURCIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E SHERMAN BLVD
MUSKEGON MI
49444-1849
US

IV. Provider business mailing address

PO BOX 776982
CHICAGO IL
60677-6982
US

V. Phone/Fax

Practice location:
  • Phone: 231-672-2000
  • Fax:
Mailing address:
  • Phone: 231-672-2119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301505692
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number4301505692
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: