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General NPI Number Information
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NPI Number | 1396044848
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Entity Type | Organization
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Legal Business Name | PARADISE MEDICAL CENTER
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Dates
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Enumeration Date | 03/23/2011
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Last Update Date | 03/23/2011
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Provider Practice Location Address
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Address Line | 8981 GEORGE AVE
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City | BERRIEN SPRINGS
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State | MI
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Zip | 49103-1407
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Country | US
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Telephone | 269-277-2541
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Fax |
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Provider Business Mailing Address
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Address Line | 8981 GEORGE AVE
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City | BERRIEN SPRINGS
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State | MI
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Zip | 49103-1407
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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 | MEDICAL DIRECTOR
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Name | DR. CHARLES MOSIMBWA
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Credential | MD
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Telephone | 269-277-2541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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