Healthcare Provider Details

I. General information

NPI: 1700445525
Provider Name (Legal Business Name): BRITTANY VALK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 03/23/2025
Certification Date: 03/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 NILES RD
SAINT JOSEPH MI
49085-3203
US

IV. Provider business mailing address

3000 OLD CENTRE RD
PORTAGE MI
49024-4883
US

V. Phone/Fax

Practice location:
  • Phone: 269-321-7546
  • Fax: 269-321-1705
Mailing address:
  • Phone: 269-321-7546
  • Fax: 269-321-1705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number5151013434
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: