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General NPI Number Information
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NPI Number | 1538195722
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Entity Type | Organization
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Legal Business Name | EUCLID MEDICAL GROUP PC
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 07/31/2020
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Provider Practice Location Address
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Address Line | 4615 EASTMAN AVE
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City | MIDLAND
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State | MI
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Zip | 48640-2610
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Country | US
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Telephone | 989-631-7110
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Fax | 989-631-7210
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Provider Business Mailing Address
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Address Line | 4615 EASTMAN AVE
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City | MIDLAND
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State | MI
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Zip | 48640-2610
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Country | US
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Telephone | 989-631-7110
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Fax | 989-892-7455
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Authorized Official
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Title or Position | CLINIC ADMINISTRATOR
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Name | MR. WILLIAM E BERNER
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Credential |
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Telephone | 989-892-7722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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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 | 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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