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General NPI Number Information
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NPI Number | 1992926877
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Entity Type | Organization
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Legal Business Name | HEALTHCARE MIDWEST PC
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/11/2010
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Provider Practice Location Address
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Address Line | 601 JOHN ST SUITE M206B
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City | KALAMAZOO
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State | MI
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Zip | 49007-5341
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Country | US
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Telephone | 269-488-8350
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Fax | 269-488-8351
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Provider Business Mailing Address
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Address Line | 4341 S WESTNEDGE AVE SUITE 2205
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City | KALAMAZOO
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State | MI
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Zip | 49008-3289
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Country | US
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Telephone | 269-373-4646
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Fax | 269-373-7655
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JAMES E MCKERNAN
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Credential |
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Telephone | 269-373-4646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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