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General NPI Number Information
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NPI Number | 1689858342
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Entity Type | Organization
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Legal Business Name | NORTHERN MICHIGAN HOSPITALISTS PC
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 1 MCBRIDE AND SON CENTER DR STE 150
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City | CHESTERFIELD
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State | MO
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Zip | 63005-1425
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Country | US
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Telephone | 636-530-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MCBRIDE AND SON CENTER DR STE 150
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City | CHESTERFIELD
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State | MO
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Zip | 63005-1425
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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 | CFO
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Name | DAVID SANDVOS
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Credential |
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Telephone | 636-530-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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