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General NPI Number Information
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NPI Number | 1396907044
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Entity Type | Organization
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Legal Business Name | ADVANCED MEDICAL MANAGEMENT SERVICES INC
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 08/21/2017
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Provider Practice Location Address
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Address Line | 3125 W MAIN ST
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City | KALAMAZOO
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State | MI
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Zip | 49006-2997
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Country | US
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Telephone | 269-345-8638
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Fax | 269-345-4308
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Provider Business Mailing Address
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Address Line | 2401 GULL RD SUITE 3
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City | KALAMAZOO
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State | MI
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Zip | 49006-2997
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Country | US
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Telephone | 269-345-8638
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Fax | 269-345-4308
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD EDWARD HARRELL
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Credential | MD
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Telephone | 269-345-8638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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