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General NPI Number Information
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NPI Number | 1972965473
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Entity Type | Organization
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Legal Business Name | MID MICHIGAN MEDICAL CORPORATION PC
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 04/05/2019
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Provider Practice Location Address
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Address Line | 863 N PINE RD SUITE E
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City | ESSEXVILLE
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State | MI
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Zip | 48732-2159
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Country | US
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Telephone | 989-895-8514
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Fax | 989-895-8516
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Provider Business Mailing Address
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Address Line | 863 N PINE RD SUITE E
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City | ESSEXVILLE
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State | MI
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Zip | 48732-2159
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Country | US
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Telephone | 989-895-5090
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Fax | 989-895-8516
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES JOSEPH
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Credential | DO
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Telephone | 989-895-5090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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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