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General NPI Number Information
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NPI Number | 1356523229
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Entity Type | Organization
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Legal Business Name | BORGESS MEDICAL CENTER
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 1521 GULL ROAD
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City | KALAMAZOO
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State | MI
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Zip | 49048
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Country | US
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Telephone | 269-226-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 5943 STADIUM DRIVE
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City | KALAMAZOO
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State | MI
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Zip | 49009
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CMO
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Name | EDWARD M MILLERMAIER
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Credential |
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Telephone | 269-552-2910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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