Healthcare Provider Details

I. General information

NPI: 1669593901
Provider Name (Legal Business Name): STEVEN H EDMONDSON DO, THERESE ROUSE DO & FRANK L SCHMID DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 N BRIDGE ST
SARANAC MI
48881-0007
US

IV. Provider business mailing address

PO BOX 7 107 N BRIDGE ST
SARANAC MI
48881-0007
US

V. Phone/Fax

Practice location:
  • Phone: 616-642-9408
  • Fax: 616-642-6940
Mailing address:
  • Phone: 616-642-9408
  • Fax: 616-642-6940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN H EDMONDSON
Title or Position: VICE PRES
Credential: DO
Phone: 616-642-9408