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NPI 1093840472

NPI 1093840472 : PHILETUS SAWYER KLEINSCHMIT SR. CRNA : BATTLE CREEK, MI

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General NPI Number Information
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    NPI Number           |    1093840472
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    Entity Type          |    Individual 
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    Provider Name        |    PHILETUS SAWYER KLEINSCHMIT SR. CRNA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/23/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    250 CENTRAL ST 
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    City                 |    BATTLE CREEK
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    State                |    MI
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    Zip                  |    49017-3313
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    Country              |    US
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    Telephone            |    269-965-1742
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    250 CENTRAL ST 
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    City                 |    BATTLE CREEK
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    State                |    MI
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    Zip                  |    49017-3313
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    Country              |    US
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    Telephone            |    269-965-1742
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    4704179305
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    License Number State |    MI
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