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General NPI Number Information
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NPI Number | 1285057471
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Entity Type | Organization
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Legal Business Name | COLDWATER ORTHOPAEDICS, PLLC
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Dates
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Enumeration Date | 01/24/2014
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Last Update Date | 01/24/2014
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Provider Practice Location Address
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Address Line | 320 E CHICAGO ST
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City | COLDWATER
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State | MI
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Zip | 49036-2068
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Country | US
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Telephone | 517-279-5050
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Fax | 517-279-5051
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Provider Business Mailing Address
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Address Line | 320 E CHICAGO ST
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City | COLDWATER
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State | MI
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Zip | 49036-2068
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Country | US
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Telephone | 517-279-5050
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Fax | 517-279-5051
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Authorized Official
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Title or Position | OWNER
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Name | MARK MAYER
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Credential | MD
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Telephone | 517-279-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301088333
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License Number State | MI
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