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NPI Code Detail

MEDICARE: EPI PC

MEDICARE: EPI PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CN0715OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10G06256OTHERMIBCBS

General Provider Information

NPI Number : 1225082266
Entity Type Code : Organization
Provider Name (Legal Business Name) : EPI PC
Provider Business Mailing Address
First Line : PO BOX 30516
Second Line : DEPT 4006
City : LANSING
State : MI
Zip : 48909-8016
Country : US
Telephone Number : 231-652-2500
Fax Number : 231-652-1452
Provider Business Practice Location Address
First Line : 602 MICHIGAN AVE
Second Line :
City : HOLLAND
State : MI
Zip : 49423-4918
Country : US
Telephone Number : 231-652-2500
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : WILLIAM HARRIS
Credential :
Telephone Number : 231-652-2500
Provider Enumeration Date : 05/22/2006
Last Update Date : 03/11/2021

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